Human Resource Forms
BENEFIT FORMS
Dental
Retiree Enrollment Form - Over 65 (pdf)
Retiree Enrollment Form - Under 65 (pdf)
Health
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)
NEW HIRE FORMS
Background Check Verification Process (Adobe web form)
Direct Deposit (Employee Self Service instructions) Note: Employee Self Service will be accessible once you are notified by UDit that your UD account has been created.)
Employee Data Sheet Packet - Staff (Adobe web form)
Employee Data Sheet Packet - Faculty (Adobe web form)
Federal Withholding Instructions (W-4) (pdf)
Online Form I-9: Section 1 (The I-9 contains two separate sections referred to as Section 1 and Section 2. The cover page for Section 1 provides critical instructions - please review this page carefully. Please contact us at 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.
* In addition to the above forms, 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
NON-EMPLOYEE FORMS
Visiting Scholar Application (tdx)
UDRI Visitor Technology Access Request (VTAR) (doc)
RETIREE or FORMER FACULTY/STAFF/GA PERSONAL DATA CHANGE
Retiree or Former Faculty/Staff/GA Change in Personal Data (Adobe web form)
W-2 TAX FORM (DUPLICATE REQUESTS)
Payroll Services will not reprint duplicate W-2s for tax year 2024 until after February 15, 2025.