Appellate Court Human Resources Forms

Leave Forms
Adoption/Childbirth Leave Application (Court of Appeals)		FMLA Physician Certification
Disability Application		Leave Donation
Employee FMLA Request		Request for Leave
Benefits Forms
Accident or Illness Report		Flex Spending Enrollment
Affidavit of Dependent Status		Group Life Insurance Beneficiary
Delta Dental of Ohio Claim		Health Benefit Enrollment/Change
Dental & Vision Enroll/Change		Supplemental Life Enrollment
Flex Spending Direct Deposit Authorization
Payroll Forms
Authorization for Direct Deposit		City Tax Withholding
Employee Address Change Form		School District Number Search
Emergency Contact Form for Judges		State Tax Withholding
Payroll Recap		W-4 Federal Tax Withholding
Payroll Deduction Card		W-5 Federal Earned Income Credit
Prior Public Service Form		Social Security Waiver Form
Other Forms
Form I-9 Employment Eligibility Verification		Homeland Security
Related Links
Credit Union of Ohio		Ohio DAS Benefits
Deferred Compensation		OPERS
Flexible Spending Account (Health Care & Dependent Care Spending Accounts Only)		Wage Works (Commuter & Prepaid parking benefits only)
Long Term Care

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