Non-Employee HR Forms

As a reminder, all employee HR forms can be found at the HR Connect Web Portal

Pre-Employment Background Checks

• Conditional Offer of Employment Medical Form
• DOI Checklist

Personal and Tax Data Changes

• Personal Tax and Data Change Form
• 2021 W4
• 2020 W4
• 2019 W4
• 2018 W4
• IT-2104
• IT-2104-E
• Withholding Certification Affirmation

Payroll and Direct Deposit

• W-2 Duplicate Request and Information Correction Form

Employment Verification

• Employment Verification Form
• Employment Verification for Pension Purposes
• Rule 3 Teaching Service Verification Form
• OT-37 Form for Verification of Paid Experience

Health Benefits

• COBRA Continuation of Coverage for Healthcare Application (and rates)
• ERB Health Benefits Application

Medical

• Employee Instructions for Workers' Compensation

Recommencement of Service

Please note: Some users may have difficulty opening the document below in the Google Chrome browser. You should be able to download the document using Microsoft Edge or Internet Explorer.

• Application for Withdrawal from Resignation/Retirement

Fingerprinting

• OSPRA 103
• OSPRA 104

Other Forms

• 211 Waiver
• Application for layoff seniority credit

Non-Employee Payment Request Form

This form is used in conjunction with the online SIPP-Program.

• Non-Employee Payment Request Form