UUP Benefit Trust Fund Change of Address Form

Please fill out the form below to electronically submit a Change of Address form to the UUP Benefit Trust Fund.

To enroll and complete a paper Change of Address form click HERE and you may fax or mail to the UUP Benefit Trust Fund.

Email: benefits@uupmail.org | Fax: 1-866-559-0516 | Mail: Benefit Trust Fund , PO Box 15143, Albany, NY 12212-9954



Employee Information:

*First name:  

Middle:  

*Last Name:  

*NYS Employee ID:  

*Non-SUNY Email:  

*Phone:  

*Date of Change:  

*Required

Old Information:

Address:  

City:  

State:  

Zip:  



New Information:

Address:  

City:  

State:  

Zip:  




*Acceptance of Terms

YES! I Agree that submission of this form constitutes my consent to an online change of address. You will receive an e-mail confirming receipt of this enrollment form. Please retain a copy of that e-mail for your records.

* Required



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