Human Resource Forms
- Adoption Reimbursement
- Continuing Education
- Dental Care
- Emergency Loan Application
- Flexible Spending
- Health Care
- Leave/Sabbatical Forms
- Life Insurance
- New Hire Forms
- Non-Employee Forms
- Outside Employment & Additional Services
- Payroll Forms
- Performance Appraisal Forms
- Personal Data Change Form
- Personnel Action Form (PAF)
- Position Classification Justification Forms
- Promotion Review Form
- Separation Forms
- Tax Forms
- Tuition Exchange
- Tuition Remission/Assistance
- Vision Plan
- Wellness Forms
- Worker's Compensation Claim Forms
Adoption Reimbursement Form (doc)
CONTINUING EDUCATION FUNDS - Center for Leadership
Center for Leadership Programs
Executive Program Form (pdf)
Retiree Enrollment Form - Over 65 (pdf)
Retiree Enrollment Form - Under 65 (pdf)
Emergency Loan Application (pdf)
Direct Deposit Enrollment Form (pdf)
Medical & Dependent Care Claim Form (pdf)
Orthodontic Claim Form (pdf)
Waiver Forms/Retiree Enrollment:
Affidavit of Spousal Eligibility for Health Care (pdf)
Affidavit of Non-Tobacco Use (pdf)
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)
FMLA/Leave/Sabbatical Form (doc)
Leave and Workers Compensation Process (pdf)
The Hartford Evidence of Insurability Form (pdf)
The Hartford Beneficiary Designation Form (pdf)
Benefits:
Social Security Number Exception Request Form (pdf)
MyCafeteria Plan Direct Deposit Form (pdf)
TIAA New Hire Flyer (pdf)
Background Check Verification Process (pdf)
Direct Deposit Form (doc)
Employee Data Sheet - Staff (doc)
Employee Data Sheet - Faculty (doc)
Federal Withholding Instructions (W-4) (pdf)
Instructions for Completing the Electronic I-9 (Employment Eligibility Verification) (pdf)
State of Ohio Withholding Certificate (IT4) (pdf)
Voluntary Self-Identification of Disability (Post Hire) (pdf)
Voluntary Self-Identification of Protected Veteran Status (Post Hire) (pdf)
W-2 Electronic Consent (pdf)
| * In addition to the above forms, Research Institute employees must also complete the following: |
New Hire Forms (pdf) Return completed form to HR
Conflict of Interest Disclosure Form (pdf) Return completed form to supervisor
Background Verification (pdf)
Non-Employee Agreement (pdf)
Non-Employee Information Sheet (pdf)
Visitor Personnel Action Form (PAF) (xls)
Visitor Technology Access Request (pdf) - applicable to UDRI non-employees only
OUTSIDE EMPLOYMENT & ADDITIONAL SERVICES
Outside Employment & Additional Services Approval Form (pdf)
Direct Deposit Form (doc)
Faculty & Staff Giving Form
Paper Leave Report for Exempt Employees (xls)
Paper Time Sheet for Nonexempt Benefit Eligible Employees (xls)
Paper Time Sheet for Nonexempt Nonbenefit Eligible Employees & Student Employees (xls)
Unpaid Personal Leave Form for Exempt Employees (doc)
General Competency Option (doc)
Goals Based Option - Version 1 (doc)
Goals Based Option - Version 2 (doc)
Mission Based Competency Option (doc)
Narrative Option (doc)
Request for Change of Personal Data Form (pdf)
Personnel Action Form (Post 7/1/19 PAF) (xlsx)
POSITION CLASSIFICATION JUSTIFICATION
Position Classification Justification Form (doc)
Position Description Guidelines (pdf)
Promotion Review Form (pdf)
Employee Separation Checklist (doc)
Separation Q&A (pdf)
Fifth Third HSA Post-Separation Fee Structure (pdf)
Federal Withholding Instructions (W-4) (pdf)
State of Ohio Withholding Certificate (IT-4) (pdf)
Employees working outside of Ohio, visit your state's revenue site to download and complete the appropriate State Withholding form.
Tuition Exchange Application (pdf)
Tuition Assistance Application for Child or Spouse (pdf)
EyeMed Out-of-Network Claim Form (pdf)
EyeMed Provider Nomination Form (pdf)
Leave and Workers Compensation Process (pdf)
Workers Compensation Form Instructions(pdf)
Workers Compensation Form Browser Help (pdf)
UD Employee Injury and Illness Report (pdf)
UD Employee Injury and Illness Supervisor Report (pdf)
UD Incident Witness Report (pdf)