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Change in Personal Information for MCPS Employees

About this Form

Form number: 445-1A

Audience:  MCPS Staff, School Staff, MCAAP Members, MCBOA Members, MCEA Members, SEIU Members, MCCSSE Members

Last revised: November 2019

INSTRUCTIONS: Please type or print. Use this form to change or correct your name, title, date of birth, and/or Social Security number (only after receipt of your new official Social Security card). (Address and telephone number changes must be made via the Employee Self-Service (ESS) web page.

Complete this form, sign, and return it to the Employee and Retiree Service Center (ERSC). You may fax the form to 301-279-3642/301-279-3651 or e-mail an electronically signed Adobe PDF file to ERSC@mcpsmd.org.

NOTES

  1. You must complete ALL sections in the first box.
  2. To change your address and/or telephone number on record with MCPS, you must visit the ESS, click on My address change, and complete the online form.
  3. You must go (in person) to your local Social Security Administration Office to complete the required form to change your Social Security records. Requested name changes will only be processed as they appear on your Social Security card.
  4. You must complete a new W-4 if you change marital status and/or number of exemptions for income tax withholding purposes. All W-4 changes are made online via ESS. To access the online form, visit the ESS web page and click on My W-4 under the green My Pay banner. Log in using your MCPS username and password and follow the on-screen instructions. After submitting your changes, you will receive an e-mail confirmation.
  5. This form does not change your name on record with the Maryland State Retirement AgencyEducational Services Federal Credit Union, retirement savings, etc.
Adobe PDF Change in Personal Information for MCPS Employees464 KEnglish

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