HR Forms

Employee Address Change

Return form to Human Resources (MS 11)

• Employee Address Change for your official employment record and all benefit providers, including PERS/OPSRP and deferred compensation.
• Address changes will only be made once HR receives a signed Change of Employee Information Form.  

Change of Employee Information Form 

Legal Name Change

Return form, in person, to Human Resources (PSB 270)

• Legal Name change requests must be accompanied by one of the following documents: updated Social Security card, updated passport, or updated US employment authorization card and presented in person.
• Legal name changes will only be processed upon Human Resources receiving signed Change of Employee Information Form.
• Employees also need to complete a W-4 for tax purposes.

Change of Employee Information Form 

Employee Benefits Forms

Return forms to Human Resources-Benefits (MS 11)

• Medical, Dental, Vision Enrollment/Change Form (ALL EMPLOYEES)
• Affidavit of Marriage or Domestic Partnership
• Dissolution of Marriage or Domestic Partnership
• Authorization for Release of Employee Benefits Information

*Additional Employee Benefits Forms are available under Benefits.

Family Medical Leave Forms

Return forms to Human Resources-Stacey Siemiller (MS 11)

• Medical Leave Request
• Release of Medical Information
• Medical Certification of Health Care Provider
• Release to Work

Payroll Forms

Return forms to Finance (MS 25)

• Direct Deposit Form
• W-4 Form