Free change of address letter 39Free change of address letter 39
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UC HUMAN RESOURCES ADDRESS CHANGE NOTICE
FOR RETIREES AND FORMER EMPLOYEES
UBEN 131 (R4/17) University of California Human Resources

Complete form in ink and send to:

UC Human Resources
Attn: Retirement Administration
Service Center
P.O. Box 24570
Oakland, CA 94623-1570

THIS FORM IS FOR RETIREES AND FORMER EMPLOYEES ONLY.

Use this form to report an address change. Fill in this form completely and send to UC Human Resources, Attn:
Retirement Administration Service Center, P.O. Box 24570, Oakland CA 94623-1570. If you recently sent us an address
change and received this form in return, we need additional information to fully update our records.
Do not use this form if you want to report a name change only. Instead, send a letter to UC Human Resources,
Attn: Retirement Administration Service Center, P.O. Box 24570, Oakland CA 94623-1570 and include your signature,
Social Security number and a copy of your marriage license or other legal documents showing the name change. Indicate
exac