Human Resources

Medical and Dental

• Retiree Enrollment Form - Over 65 (.pdf)
• Retiree Enrollment Form - Under 65 (.pdf)

Waiver Forms/Retiree Enrollment

• Retiree Enrollment Form - Over 65 (.pdf)
• Retiree Enrollment Form - Under 65 (.pdf)

Claim Forms

• Anthem Medical Claim (pdf)
• Medical Claim Form for Claims Incurred Internationally (.pdf)
• Social Security Number Exception Request Form (.pdf)

• Duplicate W-2 Request Form

New Hires

Once your UD account has been created, you can complete your Form W-4 via the Human Resources page in Porches. In the HR Self-Service block, select "Employee Dashboard." Expand the Taxes section, and click on the W-4 Employee's Withholding Allowance Certificate link to view your default W-4. Scroll to the bottom and click the Update link to make changes. If you do not complete the online Form W-4, your federal taxes will be withheld at the rate for "Single" until an online Form W-4 is completed.

Exception for International Faculty, Staff or Graduate Assistants ONLY

The University of Dayton uses Sprintax software to compile information for international faculty, staff and graduate assistants for tax compliance purposes. International employees receiving payments from the University should complete a Sprintax profile to ensure the University withholds the appropriate amount of tax from your pay. The University will identify individuals who require a Sprintax profile. If identified, you will receive an email invitation from Sprintax, which will prompt you to activate your account and complete your profile. The email will come from noreply@sprintax.com.

Contact

Please contact the Payroll Office at 937-229-2949 or payroll@udayton.edu with questions regarding the Form W-4.

All Employees

• Background Check Verification Process (Adobe web form) 
• Direct Deposit — You can access this information after your UD account has been created. 
• Employee Data Sheet Packet - Staff (Adobe web form)
• Employee Data Sheet Packet - Faculty (Adobe web form)
• Federal Withholding (W-4) — You can access this information after your UD account has been created; view instructions for more information.
• Online Form I-9: Section 1 — The I-9 contains two separate sections. The cover page for Section 1 provides critical instructions; review this page carefully. Please contact HR@udayton.edu with any questions. 
• State of Ohio Withholding Certificate (IT4) (Adobe web form) — Employees working outside of Ohio: visit your state's revenue site to download and complete the appropriate state withholding form.
  

New UD Research Institute Employees

In addition to the above forms, UD Research Institute employees must also complete the following:

• UDRI New Hire Forms (Adobe web form)
• Conflict of Interest Disclosure Form (.pdf) Return completed form to supervisor

• Visiting Scholar Application (TDX form)
• UDRI Visitor Technology Access Request (VTAR) (.pdf)

• Retiree or Former Faculty/Staff/GA Change in Personal Data (Adobe web form)