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Home >> Teachers and Teacher Certifications >> Applications & Forms >> Statement of Name Verification

Statement of Name Verification

The PDE Name Verification form is used to confirm an individual's current name when the Department has noted a discrepancy between the name listed on an application form submitted to the Department and the name listed in the educator's official records on file.

Individuals who have changed their name and wish to be issued a new certificate must submit the PDE 338 D form.

Statement of Name Verification Form (PDF)

For additional information, please contact:

Barb Seifert | Chief, Division of Certification Services
Pennsylvania Department of Education - School Leadership and Teacher Quality
333 Market Street | Harrisburg, PA 17126-0333
Phone: 717.787.3356

Questions/Technical Difficulties? Please submit a Help Desk Ticket.