Personal Data Update Form

Version 2.1

The Personal Data Update Form may be used by a current employee to request updates to his/her personal data except for changes to direct deposit information. The Direct Deposit Enrollment/Change Form should be used for changes to direct deposit information. The following documents must be attached to this form:

For change in name, a copy of Social Security card with new name
For members of Religious Order, a letter from Religious Order verifying exemption from federal tax and FICA withholding and providing Direct Deposit Information.

Please indicate which section(s) should be updated:

Employee Data
Permanent (Legal) Address
Local Address
Voluntary Self-ID

Emergency Contact
Additional Information
Dependent/Beneficiary Information

It is only necessary to complete the following:

Eagle ID
Name
Appropriate section(s) to be updated (as indicated above)
Signature with date

Select a section header to link to online instructions.

EAGLE ID
(First 8 digits on BC Eagle-One Card):

Social Security Number

I. Employee Data

Last Name		Suffix
First Name	Middle Initial	Prefix

II. Permanent (Legal) Address (for non-US citizens, please use non-US address)

Street Address	Apartment Number
Optional Address Line	Post Office Box Number
City	State	Postal Code
Country	Telephone Number (including country code and area code)

III. Local Address (if different from Permanent Address)

Street Address	Apartment Number
Optional Address Line	Post Office Box Number
City	State	Postal Code
Country	Telephone Number (including area code)

IV. Voluntary Self-Identification

Federal regulations require that all Boston College employees be identified in accordance with the standards for race and ethnicity classification developed by the U.S. Office of Management and Budget (OMB). To comply with federally mandated affirmative action reporting and analysis, Boston College must collect, report, and analyze accurate information about the Boston College workforce as a whole.

Boston College requests your voluntary assistance in meeting this important requirement by self-identification, the preferred method of employee identification. The information obtained will be kept confidential and is used only in accordance with applicable laws and regulations. For employees who do not self-identify, federal law requires Boston College to determine this information by visual survey. Thus every employee must be identified in accordance with OMB standards, either by self-identification or visual survey. If you have any questions concerning the University's legal obligation to collect and report on this data, please contact The Office for Institutional Diversity.

Marital Status
Single Married

Race or Ethnic Group (Required)

Do you have a disablility?
No Yes

Veteran Status

V. Emergency Contact

Name	Relationship
Telephone Number (including country and area code)

VI. Additional Information

If you are a member of a Religious Order please indicate:
Boston College Jesuit
Non-Boston College Jesuit or Other Religious Order
Please attach a copy of letter from Order verifying exemption from withholding and confirming Direct Deposit information.

VII. Dependent/Beneficiary Information

(This will not enroll you in any plan nor update any beneficiary information on your benefits records. This is for informational purposes only and is required of all benefits-eligible employees.)

*Student employees and other non-benefits eligible employees should not complete this section.

1.	Name			Social Security Number
	Date of Birth	Address (if different from employee)
	Relationship	Full-time Student? No Yes	Gender Female Male	Marital Status Single Married

2.	Name			Social Security No
	Date of Birth	Address (if different from employee)
	Relationship	Full-time Student? No Yes	Gender Female Male	Marital Status Single Married

3.	Name			Social Security No
	Date of Birth	Address (if different from employee)
	Relationship	Full-time Student? No Yes	Gender Female Male	Marital Status Single Married

4.	Name			Social Security No
	Date of Birth	Address (if different from employee)
	Relationship	Full-time Student? No Yes	Gender Female Male	Marital Status Single Married

5.	Name			Social Security No
	Date of Birth	Address (if different from employee)
	Relationship	Full-time Student? No Yes	Gender Female Male	Marital Status Single Married

VIII. Signature

Signature: _____________________________________ Date: ________ Ext.: ________

IX. Processing (to be completed by HRSC representative)

EAGLE ID
(First 8 digits on BC Eagle-One Card):

Processed in HRSC by:

_______________________ Date: ________

Important! Please keep a copy for your records.