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The Florida 4046 form, specifically designed for the School Board of Broward County, serves a critical purpose for employees navigating changes in their personal information. This form is primarily intended for new hires who qualify for personnel information exemption, as well as former employees seeking to update their address more than 45 days after leaving their position. It is essential for current employees and those who have recently separated from their roles to utilize the Employee Self-Service (ESS) system for address updates. The form requires the employee's name, personnel number, and both a permanent and alternate address, which may be subject to public disclosure under Florida's Public Records Law. Additionally, it addresses the need for confidentiality by allowing eligible employees to declare a confidential address, ensuring that sensitive information remains protected. To qualify for this exemption, employees must meet specific criteria and submit a Personnel Information Exemptions Form. The completion of the Florida 4046 form is not just a procedural step; it is a necessary action to safeguard personal information while complying with state regulations.

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THE SCHOOL BOARD OF BROWARD COUNTY, FLORIDA

ADDRESS CHANGE FORM

This form is to be used by new hires eligible for personnel information exemption and by former employees requesting an address change more than 45 days after their job separation date. Current employees and recently separated employees must update their

address via Employee Self-Service (ESS).

EMPLOYEE NAME:PERSONNEL #:

PERMANENT (HOME)/ALTERNATE ADDRESS: This information may be released to the public under Florida Statute 119.071

PERMANENT ADDRESS:

CITY

STATE

ZIP CODE

HOME PHONE # (Include Area Code):

OTHER PHONE # (Include Area Code):

CONFIDENTIAL ADDRESS: Florida Public Records law (Florida Statute 119.071) requires government agencies to make available upon request for public inspection most written communications and records, including personnel information about employees except for Social Security number and other specific information. However, some employees are exempt from having selected personnel information disclosed due to their job responsibilities or family relationships. To be exempt from this disclosure, eligible employees must request this exemption and declare their status by completing and submitting a Personnel Information Exemptions Form to Personnel Records Department.

Only those employees falling into one of the identified categories on the Personnel Information Exemptions Form are eligible to have selected personnel information exempt from public release – if none of the categories apply to you, you are not eligible to

request this exemption.

After the personnel exemption is identified, the Confidential Address will be entered. You must provide BOTH an Alternate

Address (above) and a Confidential Address (below). If both addresses are not provided, you will not be recorded as a confidential employee.

CONFIDENTIAL ADDRESS:

CITY

STATE

ZIP CODE

 

 

 

 

CONFIDENTIAL PHONE # (Include Area Code):

OTHER CONFIDENTIAL PHONE # (Include Area Code):

 

 

 

 

EMPLOYEE SIGNATURE:

DATE:

Submit completed, signed form to the Personnel Records Department

Form #4046 (Rev 4/12)

 

Personnel Records Department

Address Change Form 0311

Form Specifications

Fact Name Details
Form Purpose This form is used for address changes by new hires eligible for personnel information exemption and former employees who request changes more than 45 days after job separation.
Current Employees Current employees must update their address through Employee Self-Service (ESS) instead of using this form.
Public Records Law The form is governed by Florida Statute 119.071, which outlines public records requirements for government agencies.
Exemption Eligibility Eligible employees may request an exemption from having selected personnel information disclosed based on job responsibilities or family relationships.
Required Addresses Both a permanent address and a confidential address must be provided to be recorded as a confidential employee.
Submission The completed and signed form must be submitted to the Personnel Records Department for processing.
Confidentiality Certain personnel information is exempt from public disclosure, including Social Security numbers, under Florida law.
Form Revision This version of the form is identified as Form #4046 and was revised in April 2012.
Contact Information Employees must provide home and other phone numbers, including area codes, on the form.

Florida 4046: Usage Guidelines

Completing the Florida 4046 form is an important step for individuals who need to update their address with the School Board of Broward County. This process ensures that your personal information is accurately reflected in the school district's records. Follow these steps carefully to ensure that your form is filled out correctly.

  1. Begin by writing your employee name in the designated space at the top of the form.
  2. Next, enter your personnel number in the corresponding field.
  3. Fill in your permanent (home)/alternate address, including the city, state, and ZIP code. Be sure to include your home phone number and any other phone number where you can be reached.
  4. If you are eligible for personnel information exemption, provide your confidential address, along with the city, state, and ZIP code. Include your confidential phone number and any other confidential phone number.
  5. Sign and date the form at the bottom to confirm that the information provided is accurate.
  6. Finally, submit the completed and signed form to the Personnel Records Department.

After submitting your form, the Personnel Records Department will process your address change. It is essential to ensure that both your alternate and confidential addresses are provided to maintain your confidentiality if you qualify for the exemption. This will help safeguard your personal information in accordance with Florida's public records law.

Your Questions, Answered

What is the purpose of the Florida 4046 form?

The Florida 4046 form, also known as the Address Change Form, is designed for new hires who qualify for personnel information exemption and for former employees wishing to change their address more than 45 days after separating from their job. Current employees and those who have recently left their positions must update their addresses through the Employee Self-Service (ESS) portal instead.

Who should use the Florida 4046 form?

This form should be utilized by new hires eligible for personnel information exemption and by former employees who need to update their address after the 45-day window following their job separation. If you are a current employee or have recently separated, you must use the ESS portal for address updates.

What information do I need to provide on the form?

You will need to provide your name, personnel number, and both a permanent (home) address and an alternate address. Additionally, if you are requesting confidentiality, you must supply a confidential address and phone numbers. It is crucial to fill in both an alternate address and a confidential address; otherwise, your request for confidentiality may not be processed.

What is the significance of providing a confidential address?

A confidential address allows eligible employees to keep their personal information private under Florida's Public Records law. Certain employees, due to their job roles or family situations, may qualify for this confidentiality. To be considered for this exemption, you must submit a Personnel Information Exemptions Form along with the 4046 form.

What happens if I do not provide both addresses?

If you fail to provide both an alternate address and a confidential address, your status as a confidential employee will not be recorded. This means that your personal information may be subject to public disclosure, which could compromise your privacy.

Where do I submit the completed Florida 4046 form?

Once you have filled out and signed the Florida 4046 form, it should be submitted to the Personnel Records Department. Ensure that all required information is complete to avoid any delays in processing your request.

Common mistakes

  1. Failing to provide both a permanent address and a confidential address. Both addresses are required to ensure that the employee is recorded as a confidential employee.

  2. Not submitting the form within the appropriate timeframe. The form is intended for new hires eligible for personnel information exemption and for former employees requesting an address change more than 45 days after their job separation date. Current employees and recently separated employees must update their address via Employee Self-Service (ESS).

  3. Neglecting to include accurate contact information. Providing incorrect home and confidential phone numbers can lead to difficulties in communication regarding important personnel matters.

  4. Overlooking the requirement to submit a Personnel Information Exemptions Form if applicable. Employees must declare their status to be exempt from public disclosure. Only those who meet specific criteria can request this exemption, and failure to do so may result in personal information being publicly accessible.

Documents used along the form

The Florida 4046 form, known as the Address Change Form, is essential for new hires and former employees who need to update their address. However, several other forms and documents often accompany this process to ensure compliance with various regulations and policies. Below is a list of related documents that may be necessary.

  • Personnel Information Exemptions Form: This form allows eligible employees to request an exemption from public disclosure of certain personnel information due to their job responsibilities or family relationships. It must be submitted to the Personnel Records Department.
  • Employee Self-Service (ESS): Current and recently separated employees are required to use this online platform to update their address. It streamlines the process and ensures that changes are recorded promptly.
  • Confidentiality Agreement: This document may be necessary for employees who qualify for confidentiality under Florida law. It outlines the terms under which personal information is protected and specifies the rights of the employee.
  • Proof of Residency: Employees may need to provide documentation verifying their new address, such as a utility bill or lease agreement. This helps confirm the accuracy of the information submitted.
  • Employee Handbook Acknowledgment: This form confirms that employees have received and understood the policies outlined in the employee handbook, including those related to address changes and confidentiality.
  • Separation Notice: For former employees, this document serves as a record of their job separation and may be required when submitting the Address Change Form more than 45 days after leaving the position.

Understanding these forms and their purposes is crucial for ensuring a smooth transition during the address change process. If you need assistance with any of these documents, it is advisable to reach out to the Personnel Records Department promptly.

Similar forms

The Florida 4046 form, known as the Address Change Form for the School Board of Broward County, serves specific purposes related to employee information. Several other documents share similar functions or processes. Here’s a look at five such documents:

  • Personnel Information Exemptions Form: This form allows employees to declare their eligibility for personnel information exemptions. Like the Florida 4046 form, it requires specific information about the employee and is crucial for protecting sensitive data.
  • Employee Self-Service (ESS): This online platform enables current employees to update their personal information, including addresses. Similar to the Florida 4046 form, it ensures that employee records are accurate and up to date, though it is more automated and accessible.
  • Request for Public Records Form: Under Florida's public records law, this form is used by individuals requesting access to government documents. It parallels the Florida 4046 form in its focus on transparency and the handling of personal information, though it is typically used by external parties rather than employees.
  • Employment Verification Form: This document is often used by employers to confirm an employee's job status and address. Like the Florida 4046 form, it involves personal information and ensures that records are accurate for verification purposes.
  • Change of Address Notification Form: This form is commonly used in various organizations to inform them of an employee's new address. Similar to the Florida 4046 form, it serves the purpose of keeping contact information current and may be required for various administrative processes.

Dos and Don'ts

When filling out the Florida 4046 form, it’s important to follow certain guidelines to ensure your information is processed correctly. Here’s a list of things you should and shouldn’t do:

  • Do read the instructions carefully before starting the form.
  • Do provide both a permanent and a confidential address.
  • Do include your current phone numbers, both home and confidential.
  • Do sign and date the form before submission.
  • Do submit the form to the Personnel Records Department promptly.
  • Don't leave any required fields blank; incomplete forms may delay processing.
  • Don't forget to check if you qualify for personnel information exemption.
  • Don't use abbreviations or unclear language in your addresses.
  • Don't submit the form more than 45 days after your job separation if you are a former employee.
  • Don't assume your information is confidential without completing the necessary forms.

By following these guidelines, you can help ensure a smooth process when updating your address with the School Board of Broward County.

Misconceptions

Misconceptions about the Florida 4046 form can lead to confusion regarding its purpose and use. Here are nine common misunderstandings:

  1. This form is for all employees. The Florida 4046 form is specifically for new hires eligible for personnel information exemption and former employees requesting an address change more than 45 days after job separation.
  2. Current employees can use this form to change their address. Current employees must update their address through Employee Self-Service (ESS), not by using this form.
  3. Submitting this form guarantees confidentiality. Only eligible employees can have their information exempt from public release. Simply submitting the form does not ensure confidentiality.
  4. All employees are eligible for the exemption. Only those who meet specific criteria, such as job responsibilities or family relationships, can request exemption from public disclosure.
  5. Only one address is needed. To be recorded as a confidential employee, both an Alternate Address and a Confidential Address must be provided on the form.
  6. Social Security numbers are protected under this form. While Social Security numbers are exempt from public release, other personnel information may still be disclosed unless the exemption is granted.
  7. This form can be submitted anytime. Former employees must submit the address change request more than 45 days after their job separation date to be eligible.
  8. All information on the form is confidential. The form includes sections that may be released to the public under Florida Statute 119.071, unless an exemption applies.
  9. It’s enough to just declare your status. Employees must complete and submit a Personnel Information Exemptions Form to be considered for confidentiality.

Understanding these misconceptions can help ensure that the Florida 4046 form is used correctly and effectively.

Key takeaways

  • Eligibility: The Florida 4046 form is specifically for new hires eligible for personnel information exemption and former employees requesting an address change more than 45 days after job separation.
  • Current Employees: Current employees and those who have recently separated must update their address through Employee Self-Service (ESS) instead of using this form.
  • Address Requirements: You must provide both a permanent/alternate address and a confidential address. Incomplete submissions will not be accepted.
  • Confidentiality: Only employees who meet specific criteria can request exemption from public disclosure of selected personnel information. Ensure you understand the eligibility requirements.
  • Submission: After completing the form, submit it to the Personnel Records Department for processing. Ensure it is signed and dated.
  • Public Records Law: Familiarize yourself with Florida Statute 119.071, which governs the release of personnel information and outlines what can be disclosed.