Auburn University - PEB - Forms

Business Office

Employee Benefits

Payments/Non-Resident Aliens

Forms

Payroll

Alabama Dept. of Revenue Form A-4, Employee's Withholding Exemption Certificate
Direct Deposit Authorization*
(please print on light blue paper)
Employee's Withholding Exemption Certificate
(For City of Auburn Occupation License Fee)
IRS Form W-4, Employee's Withholding Allowance Certificate
Late Pay Form
Monthly Payroll Verification and Leave Summary
Overpayment Certification
Recap Time Sheet
Replacement Check Request*
Request for Reissued IRS Form W-2*
Special Payment Form

Payments to Non-Resident Aliens

Employee Benefits

Change of Beneficiary Form Prior to Retirement - 100-C (Retirement Systems of Alabama)
Please print this two page form on a single page - page one on the front/page two on the back.
Life Insurance Change Form (The Standard)
Supplemental Insurance Cancellation*
Tobacco Usage Certification*
Voluntary Salary Deferral Agreement 403(b)*
For use effective 01/01/2012
Voluntary Salary Deferral Agreement 457(b)*
For use effective 01/01/2012
Salary Reduction Agreement and COBRA Notice
Applicable Enrollment Forms
· Health and Dental Insurance and Tobacco Usage Certification
· Vision Insurance
Dependent Verification Documents

Flexible Spending Accounts

* Forms may be filled in online then printed

Payroll & Employee Benefits
212 Ingram Hall Auburn University, AL 36849 Phone 334-844-4183 Fax 334-844-1799

Auburn University | Auburn, Alabama 36849 | (334) 844-4000
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