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INSTRUCTIONS: ARIZONA ADDRESS AND NAME CHANGE FORM (Form 9)

To document an address or name change, Arizona public safety employees, elected officials and corrections officers who are active or retired should file a form 9 if they were enrolled in a state-administered retirement fund. This document can be obtained from the website maintained by the Elected Officials' Retirement Fund of the State of Arizona.

Arizona Address And Name Change Form 9 Step 1: On the first line of Section 1, enter your name and indicate the type of account with a check mark.

Arizona Address And Name Change Form 9 Step 2: On the second line, enter your SYSID (if known) and date of birth. If you are the ex-spouse of an enrolled member, enter their name.

Arizona Address And Name Change Form 9 Step 3: On the third line, enter your last name, first name and middle initial.

Arizona Address And Name Change Form 9 Step 4: On the fourth line, enter your email address.

Arizona Address And Name Change Form 9 Step 5: On the fifth line, enter your home phone number, cell phone number and work phone number.

Arizona Address And Name Change Form 9 Step 6: On the first line of Section 2, enter your primary mailing address. 

Arizona Address And Name Change Form 9 Step 7: On the second line, enter your city, state and zip code.

Arizona Address And Name Change Form 9 Step 8: If filing to document a change of address, enter the new street address on the third line and your new city, state and zip code on the fourth lien.

Arizona Address And Name Change Form 9 Step 9: If documenting a name change, enter your current and new full names in Section 3. You must attach a copy of a legal document showing your new name.

Arizona Address And Name Change Form 9 Step 10: Sign and date section 4. Those who are signing with a power of attorney or as a guardian who have not previously filed this certification must attach a complete copy of their legal appointment.

Arizona Address And Name Change Form 9 Step 11: If non-retired, mail or fax the form to the numbers specified at the top of the page. Otherwise, use the fax number provided for retired members.