All Forms

Health and Wellness

All enrollments, terminations and changes to health and wellness plans must now be done online through the employee’s web benefits portal by requesting a life event.  The employee should access their Paylocity account, click on “Applications” and then on “Enterprise Web Benefits”.  From that page, they can create a request for a life event.  Click here for instructions on how to request a life event.  Please contact HR for additional information.

Benefits Summary – Full Time (full-time, working 30 hours or more per week during a school year or calendar year)

Medicare Notice of Creditable Coverage 2017

Disability and Life Insurance Forms

Life insurance beneficiaries are to be designated online in the Paylocity web benefits portal.  Click here for instructions.  Enrollment into Basic Life and Long Term Disability are automatic.  Enrollment for Voluntary Life and Short Term Disability are optional and only offered once a year during open enrollment.

Retirement Forms

Retirement Plan Beneficiary Form (this form only applies to the pension plan – employees hired before January 1, 2012 who are participants in the Grandfathered Pension Plan.  Keep completed form at your location and mail a copy to address indicated on form.  Do not send to Human Resources).  To designate a beneficiary for the 403(b) retirement plan, please log onto your account at www.archindyretirement.org.

Tax and Payroll Forms

2018 W-4 Federal Tax Withholding Form – only use for a new hire not doing online onboarding; current employees must change their withholding in their Paylocity self-service portal.

WH-4 Indiana State Tax Withholding Form – only use for a new hire not doing online onboarding; current employees must change their withholding in their Paylocity self-service portal.

Payroll Action Form – for supervisor use only

Employment Forms

Employment Application

Reference Check Form

Employee Emergency Notification

I-9 Form – 2017  (Click I-9 Instructions – 2017 for instructions)

Employment Law Manual – updated April, 2017

Code of Conduct

Safe and Sacred

Performance Development Process

Staff Member Questionnaire (self-appraisal)

Supervisor Form (fillable PDF)

 

2018 Guides

2018 Benefits Summary for Part Time  (part-time employees)

2018 Benefits Summary for Full Time (full-time employees)

Retirement Plan Summary

Professional Development Forms

These forms can now be found on the finance page of the Archdiocese website, www.archindy.org.  Click here to be taken directly to that page.

You are the Face of the Church

Family and Medical Leave Act (FMLA) Forms

FMLA Notice of Rights

FMLA Request Form