Transcription of AD-349, Employee Address
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AD-349, Employee Address
FORM AD-349(REV. 12/93)AGENCY USEAGENCY1. NAME (Last, First, Middle)2. SOCIAL SECURITY STREET Address OR BOX5. CITY NAMECITY CODE6. STATE or COUNTRY NAME7. ZIP CODE13. SIGNATURE OF EMPLOYEE14. DATE DEPARTMENT OF AGRICULTUREEMPLOYEE ADDRESSACTIONCODEEFFECTIVEDATESECTION IComplete Section I with your current or new residence mailing Address . This Address is used tomail out Employee Pay and TSP statements, W-2 forms and other personal documents. NOTE: This form does not change the Savings Bond APT USECOUNTY CODESTATE OR COUNTRY CODESECTION IIFOR EMPLOYEES WITH DIRECT DEPOSIT COMPLETE BLOCKS 13 AND 14 who wish to receive their checks in the mail complete blocks 8 through 14 withyour current or new check mailing STREET Address or BOX10. CITY NAMECITY CODE11. STATE or COUNTRY NAME12. ZIP CODE9. APT USECOUNTY CODESTATE OR COUNTRY CODEI nformation Regarding Disclosure of Your Social Security Number Under Public Law 93-579 Section 7(b) (Privacy Act of1974)Disclosure by you of your Social Security Number (SSN) is mandatory to obtain the services, benefits, or processes that youare seeking.
mail out employee Pay and TSP statements, W-2 forms and other personal documents. NOTE: This form does not change the U.S. Savings Bond address. 4. APT NO. AGENCY USE COUNTY CODE STATE OR COUNTRY CODE SECTION II FOR EMPLOYEES WITH DIRECT DEPOSIT COMPLETE BLOCKS 13 AND 14 ONLY.
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