To:          NTEU President, Chapter 46                                                              Date:__________________

                MC 1700 DAL

Subject:    Change of Address and/or Telephone Number

1.  Please update the local and national NTEU records to show my new home address/telephone # as follows:

Name: ____________________________                         SSN: _____________________________

New Address: _____________________________                 New Home Phone:__________________

                       _____________________________               E-Mail Address:__________________

                       _____________________________

2.  Please update the local and national NTEU records to show my new IRS office address/telephone # as follows:

Name: ____________________________                         SSN: _____________________________

New Address: _____________________________                 New Office Phone:__________________

                       _____________________________               IRS E-Mail Address:__________________

                       _____________________________

Instructions: Print this form on your printer, fill out form and send it back to Chapter 46, via MC:1700 DAL or mail to: NTEU Chapter 46, P.O. Box 50109, Dallas, TX 75250.