Paid Dining Assistant
Name and Address Change

To request an address change, you may fill out the address change form or contact Ty Baskin at (402) 471-4910 or email at tyrone.baskin@dhhs.ne.gov   Be sure to include your name and date of birth if you mail, fax, or email your address change.

In order to change your name, you must mail or fax the name change form or a written request with your signature notarized along with a copy of the marriage certificate, divorce decree, or other court record verifying your name change. (A driver's license or Social Security Card may also be used a documentation as long as it shows the new name.) Be sure to include your social security number on the document you submit.