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Direct Deposit (Enrollment/ Change)

 
Employment
Changes

 
Work Related
Injury (Worker' s Comp)


 
To View and Print Forms
These forms are in the Adobe Acrobat (pdf) format.

In order to view or print the forms on this page, you must first have the Acrobat Reader installed on your machine. (We recommend version 6.0).

Should you need the reader, we have provided a link below to obtain the free program directly from the Adobe website.

INSTALL ADOBE ACROBAT

Tax Withholding Forms

Printable W-4 Form

This form is used to change your federal filing or exemption status with payroll.

In order to view or print the W-4 form, you must first have Adobe Acrobat Reader installed on your PC. Should you need the reader, use the link to the left titled Install Adobe Acrobat before continuing.


You can print the form and fill in the W-4 manually.


Follow these steps to print and fill out manually:
  1. Make sure Adobe Acrobat Reader is installed on your PC. (If form will not open, use link to the left.)
  2. Open W-4 form.
  3. Once the form appears, click on the print icon on the top toolbar.
  4. Fill out form including signature and date (the worksheet area is not required) and either send back to Payroll in inter-office mail or fax to 812-435-5027.

Tax Adjustment Request Form

This form is used to request that your federal taxes be adjusted on a final buyout check with payroll.

In order to view or print the Tax Adjustment form, you must first have Adobe Acrobat Reader installed on your PC. Should you need the reader, use the link to the left titled Install Adobe Acrobat before continuing.


You can print the form and fill in the Tax Adujustment form manually.

Follow these steps to print and fill out manually:
  1. Make sure Adobe Acrobat Reader is installed on your PC. (If form will not open, use link to the left.)
  2. Open Tax Adjustment Request form.
  3. Once the form appears, click on the print icon on the top of the form.
  4. Fill out form including signature and date and either send back to Payroll (Leslie Saiko or Rose White) in inter-office mail or fax to 812-435-5027.

WH4 Form (State Withholding)

This form is used to change your Indiana state filing or exemption status with payroll.

In order to view or print the WH4 form, you must first have Adobe Acrobat Reader installed on your PC. Should you need the reader, use the link to the left titled Install Adobe Acrobat before continuing.


You can print the form and fill in the WH4 manually or you can fill out the form by entering your information directly into the form; print; and sign and date. If you fill out the form online, be sure and use the print button located in the upper right-hand corner to print the form. If you do not use either the Print or Reset button on this form, then your data will appear for the next person that uses this form. The reset button will also clear the form.


Follow these steps to print and fill out manually:
  1. Make sure Adobe Acrobat Reader is installed on your PC. (If form will not open, use link to the left.)
  2. Open WH4 form.
  3. Once the form appears, click on the print icon at the top of the form.
  4. Fill out form including signature and date (the instruction sheet on the second page is not required) and either send back to Payroll in inter-office mail or fax to 812-435-5027.
Follow these steps to fill out the WH4 online:
  1. Make sure Adobe Acrobat Reader is installed on your PC. (If form will not open, use link to the left.)
  2. Open WH4 form.
  3. Once the form appears, use either the TAB key or your mouse to fill in areas. (The instruction sheet on the second page is not required.)
  4. Use the Print & Reset button at the top of the form. If you do not use this button to print, your data will be available to the next person to use this form.
  5. Be sure that all the information is correct; sign and date; and either send back to Payroll in inter-office mail or fax to 812-435-5027.

Any comments or questions, email a contact.


 
     
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