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Vanderburgh County Payroll - Forms Available
Note: To print the following forms, be sure to use the "Print & Reset" button at the bottom of the form. If you do not use either the "Reset" or "Print & Reset" button, then your data will appear for the next person that uses the form.
Tax Withholding FormsThese forms are used to change your federal or state filing or exemption status with payroll or to request that your federal taxes be adjusted on a final buyout check with payroll. Since a signature is required on these forms, the W-4, WH4 and Tax Adjustment forms need to be printed and sent back to the Bookkeeping Department of the Auditor's Office. Use the link to the left to access the Tax Withholding Forms.
Address ChangeThe form provided on this page will only change your address with payroll. When you send this form to the Bookkeeping Department of the Auditor's Office, you still need to change your address with:
Use the Retirement link under Benefits (left navigation bar) to access P.E.R.F. to change your address for
your retirement plan. If you are a Sheriff's Deputy, under the Sheriff's Retirement Plan, you need to contact Jason Asworth,
Sheriff's Pension Secretary.
Direct Deposit Enrollment and ChangeThe Direct Deposit Enrollment form must be printed and signed before returning to Leslie Saiko in the Bookkeeping Department of the Auditor's Office. Use the Direct Deposit (Enrollment) link to the left to enroll for direct deposit. This will remain in effect until Vanderburgh County has received written notification of its termination.
The Direct Deposit Change form must be printed and signed before returning to Leslie Saiko in the Bookkeeping Department of the Auditor's Office. Use the Direct Deposit (Change) link to the left to change or cancel your direct deposit.
Employment ChangesThe Employment Changes form is to be used by Vanderburgh County Department heads to submit to the Commissioners for approval. The form must be printed and signed by the Office Holder before returning to Payroll in the Bookkeeping Department of the Auditor's Office. To be brought before the Tuesday Commission meeting, the form should be turned in to payroll before 12:00 Noon on the Friday preceding the meeting. Use the Employment Changes link to the left to access the form.
Work Related Injury (Worker's Comp) FormsThe Work Related Injury forms are to be used by Vanderburgh County Department heads to submit to the County Council. The forms should be completed and sent to the County Council office any time an employee sustains a work related injury, regardless of whether he/she seeks medical attention. Please call Teri Lukeman, County Council Executive Assistant, at 812-435-5790 or email her at TLukeman@vanderburghgov.org with any questions. Use the Work Related Injury (Worker's Comp) link to the left to access the forms.
Any comments or questions, email a contact.
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