Download PDF
Summary
Please be sure to provide your date of birth and your Social Security number or ETF ID, and sign the form before submitting.
- Retirees, inactive members, and other benefit recipients: Use this form to update your name, address, or gender on file with ETF. Submit the form by mail or fax, or drop off, to ETF.
- Active employees: Notify your employer to update your name, address, or gender on file with ETF instead of submitting this form. They must update your information on file with ETF. Your employer may request you complete this form only if you are changing your gender; they will submit your completed form to ETF.
Please note:
- Insurance subscribers may use this form to make changes to your insured dependent’s name and gender. (Complete Section 1 on page 1, and complete page 2.)
- To update beneficiary information, including beneficiary contact information, you must submit a new beneficiary designation form.
- Your full mailing address is important so you will continue to receive valuable information about your Wisconsin Retirement System benefits. Be sure to include any apartment, room, lot, or suite number. Include your P.O. Box number if mail is not delivered to your street address.
- Only the member or authorized representative may update their information using this form. If you are a representative signing on behalf of the member, ETF must have a copy of your approved power of attorney on file. ETF will not complete an address change from an unauthorized third party.