Complete this form to notify us of a change in your mailing address and/or home address or of a change in your telephone number. Please fill out completely. If you need assistance with the form, contact: Serving beneficiaries, last name starting with A-L, Vanesa Macias, Account Technician, at 909-382-4678 Serving beneficiaries, last name starting with M-Z, Hazel Harmon, Account Technician, at 909-890-3427