Forms
Forms are grouped by category:
HR/PAYROLL FORMS
- Personnel Actions application – Add, change, or end jobs for staff, temps, and post docs. If you have questions regarding access or functionality, please first contact your Business Manager. For additional support, contact askHR (askhr@nd.edu, 631-5900).
- Exempt Staff Vacation/Leave Reporting Application – MyTimeOff.nd.edu
- Staff Position Management Form
EMPLOYMENT
Employment Eligibility Verification (Form I-9)
Verification is a two-step process: Following the completion of Section One online, you may present unexpired documentation to verify your identity and employment authorization to the Office of Human Resources 200 Grace Hall, by appointment only. In order to make an appointment during our open hours of 8 am until noon on Tuesday and Friday only, please email askhr_i9compliance@nd.edu or call askHR at 574-631-5900.
More about the Employment Eligibility Verification (Form I-9) process.
Tax Withholding Forms
Withholding now online. New hires (or employees who desire to make changes) must make tax withholding elections using the Tax Withholding Elections app on insideND.
Online entry of state/county withholding is available to residents of Indiana and Michigan. University employees who both reside and work outside of Indiana or Michigan should contact Payroll Services at 574-631-7575 prior to submitting their state/county withholding elections.
Direct Deposit
Direct deposit now online. New hires (or employees who desire to make changes) must make direct deposit elections using the Direct Deposit app on insideND.
- Direct Deposit Instructions (PDF).
Recruitment
Exit Interview
BENEFITS
Absences and Leaves
- UND Return-To-Work/Work Release form (PDF)
- Military Leave Supervisor Checklist (PDF)
- Leave of Absence Form Instructions
Education Benefits
- Degree Seeking Application for Employee and Employee Spouse Educational Benefit (PDF)
- Application for Educational Benefits for Children of Employees (PDF)
- Fred E. Freeman Staff Scholarship Fund Application (PDF)
- Non-Degree Seeking Application for Employee and Spouse Educational Benefit (PDF)
- Non-Notre Dame Tuition Reimbursement (PDF)
Flexible Spending Accounts
Group Life Benefits
- Evidence of Insurability – Minnesota Life – 198KB (PDF)
- Retiree Life Insurance Beneficiary Designation Form (DOC)
Long Term Disability Benefits
LTD claim forms have been eliminated as of July 1, 2015. For information on filing an LTD claim, visit the Long Term Disability page.
Medical, Dental and Vision Benefits
- Benefits Enrollment and Qualifying Event Information
- Anthem Medical Claim Form (PDF)
- Delta Dental Claim Form (PDF)
- EyeMed Out of Network Claim Form (PDF)
Prescription Drug Benefit
- OptumRX Prescription Home Delivery Form (English) (PDF)
- OptumRX Prescription Home Delivery Form (Spanish) (PDF)
- Member Reimbursement Drug Claim Form (PDF)
Retirement
Employee Contribution Forms
- As of January 2015, voluntary contribution elections are now paperless. To begin, change or cancel your voluntary contributions, log in to netbenefits.com/nd or call Fidelity at 877-963-0242.
Fidelity Forms
- Fidelity Transfer Rollover Form (PDF)
- As of January 2015, many 403(b) processes are now paperless. To change your beneficiaries, contributions or investment elections, log in to netbenefits.com/nd or call Fidelity at 877-963-0242.
Pension Plan Forms
- Beneficiary Designation Form
- Withholding Certificate for Pension or Annuity Payments Form W-4P (PDF)
- Indiana State Withholding Certificate for Pension or Annuity Payments Form WH-4P (Click on WH-4P to access PDF)
Other
- To request a temporary NetID for an affiliate you will need to complete the Affiliate Access Process. (Notre Dame NetID required)
- Adoption Form
COMPENSATION
Staff Position Management Form
Additional Pay for Services
ORGANIZATIONAL
Performance
LifeWorks/Employee Assistance Program
- Release of Information – Management Consultation/Work Issues
- Release of Information – Substance Abuse
INFORMATION CHANGES
Withholding
Withholding now online. New hires (or employees who desire to make changes) must make tax withholding elections using the Tax Withholding Elections app on insideND.
Online entry of state/county withholding is available to residents of Indiana and Michigan. University employees who both reside and work outside of Indiana or Michigan should contact Payroll Services at 574-631-7575 prior to submitting their state/county withholding elections.
- Federal Tax Withholding Form W-4
- Indiana Taxwithholding Form W-4 (Click on WH-4 to access PDF)
- Michigan Form W-4
- Illinois Taxwithholding Form W-4
Personal
AWARDS
- Team Irish Award Nominations
- Presidential Award & Notre Dame Award of Merit Nomination – Closed
OTHER
- Employee Compassion Fund Information and Form
- HR Reporting Access Request (People EZ and others)
AskHR Top 5 FAQs
- How can I get a new Anthem ID card?
- How do I change my HSA contribution?
- How can I receive a free second opinion on my care if I am hospitalized with COVID-19?
- Where can I get a COVID-19 test in the community?
- How do I change my 403b voluntary election? How do I schedule a confidential one-on-one consultation with a Fidelity Planning and Guidance Consultant regarding my UND 403(b) Retirement Plan?