Office of the Vice President for Information Technology
University Information Technology Services
Human Resources Office

Commonly used Forms

Some of these are web-based submission forms. Some are forms to be printed, filled out and sent in for processing. Some of these require the use of Adobe Acrobat. Unless otherwise indicated, the form displayed is used for all campuses.

Employment

• Background check consent form
• Part-time hourly Application form
• Payroll: Use the Employee Center on OneStart to initiate or revise home address, direct deposit, tax withholding and to view paystubs
• Business cards order form

• Online User Agreement form

Benefits

Health and Medical
• Anthem Medical Claim Form

• Anthem Drug Formulary Quick Reference

• Prescription Drug Claim Form

• Prescription Mail Order form/instructions

• Health Savings Account

• Tax Saver Benefit

• Dental Claim Form

• Cigna Dental Membership Card
• Group Life Insurance Beneficiary Designation

• Supplemental Life Insurance Enrollment

• Supplemental Life Insurance Beneficiary Designation

• Employee Statement of Health

Leave
• FMLA Department of Labor Poster

• FMLA Request Form

• FMLA Medical Certification: Self Care

• FMLA Medical Certification: Immediate family member care

• Certification of Qualifying Exigency for Military Family Leave

• Certification for Serious Injury or Illness of Covered Service Member

• FMLA Fitness/Intent to Return to Work

Other
• Tuition discount form

• Ergonomic Evaluation Request IUB

• Ergonomics Regulatory Guide

• Occupational Injury

• All jobs at IUB

• All jobs at IUPUI

• Benefits

• UITS Staff Handbook

• Commonly Used Forms

• UITS Phonelist

• UITS Organizational Charts

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• Vice President for Information Technology
• OVPIT/UITS HR

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• Last updated: 14th February, 2013