University of Denver Bursar’s Office
University Hall 223
2197 S. University Blvd.
Denver, CO 80208
(303)871-4944 fax (303)871-4401
[email protected]
NAME CHANGE REQUEST FORM
Federal Perkins Loan
Date of Request
BORROWER INFORMATION
DU ID #
Last 4 of SSN
Former Name
UPDATED INFORMATION
Legal Name
Reason for Change
CONTACT INFORMATION
Address
Email
Phone (Day)
(Cell)
I certify that all of the information on this form is complete and correct.
Borrower Signature
Date
Please provide a photocopy of legal documentation along with this form.
(i.e. marriage certificate or drivers license.)
FOR OFFICE USE ONLY
Completed By
Date