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Faculty and Staff Forms

Deferred Compensation Enrollment Document icon
 Deferred Compensation Enrollment Form
Deferred Compensation Salary Deferral Agreement Document icon
Pennsylvania Deferred Compensation Program Form
Direct Deposit Document icon
Please include a voided check with the direct deposit application
Dual Compensation Form Document icon
Request Form for Dual Employment
Employee's Nonwithholding Application Certificate Document icon
Application for exemption of withholding of Pennsylvania state tax.  Residents of Indiana, Maryland, New Jersey, Ohio, Virginia or West Virginia should complete this form to have tax withheld for his/her state of residence.
Faculty Pay Schedule for 2014-2015 Document icon
Faculty pay schedule for academic year 2014-2015.
I-9 for 2015 Document icon
2015 I-9 form to be completed for employment.  Needs to be submitted to the Payroll Office.
Local Services Tax - Exemption Certificate - 2015 Document icon
Local Services Tax - Exemption Certificate 2015 - Tax Year Application for Exemption from Local Services Tax
Manager Working From Home Reporting Form Document icon
Time Reporting form for managers working from home (Excel)
Personal Data Summary Sheet Document icon
Form needs to be completed by non-credit employees only.
Residency Certification Form: Change of Address Document icon
This form is to be used by employers and/or taxpayers to report essential information for the collection and distribution of Local Earned Income Taxes.
Savings Bond Form Document icon
Savings Bond direct deposit authorization form
SCUPA (Full-Time) Time and Attendance Form Document icon
Time sheet for full-time SCUPA employees
SCUPA (Part-Time) Time and Attendance Sheet Document icon
Time sheet for part-time SCUPA employees
Statement Of Citizenship Status Document icon
Please fill this form out yearly if you are a nonresident alien.
Time and Attendance Document icon
Time and Attendance Form
Tax-Sheltered Annuity 403(b) Salary Reduction Agreement Document icon
Enrollment/change form for the Tax-Sheltered Annuity 403(b) plan.
Withdrawal of Consent to Electronic W-2 Document icon
Use this form only if you have consented to electronic-only delivery of your W-2 but have changed your mind and now want the State System to send your W-2 via U.S. mail.
W-4 for 2015 Document icon
Form W-4, ensures your employer can withhold the correct federal income tax from your pay
  • Payroll Services Office
  • Sutton Hall, Room G11
    1011 South Drive
    Indiana, PA 15705
  • Phone: 724-357-2510
  • Fax: 724-357-7551
  • Office Hours
  • Monday through Friday
  • 8:00 a.m.–4:30 p.m.