- Feature Links
- Employees
- Change of Name / Address
Change of Name / Address
Change of Name
Should be done within 30 days of the qualifying event.
Step 1:
- Fill out a new 2023 W-4 and M4 Form (PDF)
- Submit to the Treasurer's Office at the Town Hall
Step 2:
- Complete the following tasks for all that are applicable to you.
- Health Insurance:
- Fill out a new Health Insurance Enrollment Form (PDF) and provide a copy of the city / town issued Marriage Certificate or Court Judgement.
- Enrollment forms are also available at the Treasurer's Office
- Give both items to the Treasurer's Office at the Town Hall.
- Dental Insurance:
- Fill out a new Dental Insurance Enrollment Form and provide a copy of the city / town issued Marriage Certificate or Court Judgement
- Enrollment forms also available at the Treasurer's Office
- Give both items to the Treasurer's Office at the Town Hall
- Franklin Regional Retirement:
- Fill out a Status Change Form (PDF) and provide a copy of your new social security card
- Give both items to the Treasurer's Office at the Town Hall
- Massachusetts Teacher Retirement:
- Contact Brenda Antes at the Superintendent's Office
- American Fidelity (Accident, Cancer, Disability, FLEX, Life, Texas Life):
- Fill out a Name Change Form (PDF) and fax it to the number provided on the form
- Health Insurance:
Change of Address
Should be done as soon as possible.
Step 1:
- Fill out a new 2022 W-4 Form (PDF) and M4 Form (PDF)
- Submit to the Treasurer's Office at the Town Hall
Step 2:
- Complete the following tasks for all that are applicable to you.
- Franklin Regional Retirement:
- Fill out a Status Change Form (PDF)
- Submit to the Treasurer's Office at the Town Hall
- Massachusetts Teacher Retirement:
- Contact Brenda Antes at the Superintendent's Office
- American Fidelity (Accident, Cancer, Disability, FLEX, Life, Texas Life):
- Fill out an Address Change Form (PDF) and fax it to the number provided on the form
- Contact the Treasurer's office for your Policy Number at 413-665-1400, ext. 101
- Franklin Regional Retirement: