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Report changes to employment

Please fill out the form and submit to the CSEA to report a change in your employment.

Case Information
Sets Number       (Example: 7123456789)
Court Case Number      (If known)

Personal Information
*Last Name: ,       *First Name:       Middle Initial:
* Your Current Address:
*City: ,       *State: .       *Zipcode:
*Date Of Birth:             *Social Security Number :
Phone Number:
Email Address:

Employer's Information
*Employer's Name:
*Employer's Address:
*City: ,       *State: .       *Zipcode:
Start Date:             Phone Number:

Would you like to receive email correspondence from the CSEA instead of receiving documents through the US Postal Service?
Yes    No

* are required fields

Butler County CSEA | Executive Director Julie Gilbert | Assistant Director Narka Gray 
Government Services Center, 7th Floor, Hamilton, OH 45011

Phone (513) 887-3362 | Fax (513) 887-3699

Board of Commissioners: Donald L. Dixon, T.C. Rogers, Cindy Carpenter