Forms: Payroll, Ball State University

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Payroll and Employee Benefits

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Payroll and Employee Benefits

Administration Building
Room G29
2000 W. University Ave.
Muncie, IN 47306
Phone: (765) 285-8461
Fax: (765) 285-6612
PEB@bsu.edu
Hours: 8 a.m.- 5 p.m. Eastern Time

Insurance

Anthem Mail Order Form

Domestic Partner

Flex Plan Enrollment Form

Flexible Spending Dependent Debit Card Request

FlexProTM Claim Form

Group Health Enrollment Form

Group Health Claim Form

Dental Claim Form

Benefits at a Glance - FY 2009

HIPAA Privacy Release Form

BSU Life Insurance Beneficiary Change Form

Premium Conversion Form

Retiree Health Care Enrollment Form

Chronic Disease List

Voluntary Retirement Savings

403(b) TDA (Tax Deferred Annuity) Agreement Form

403(b) Roth (after tax) Agreement Form

457(b) Deferred Compensation Agreement Form

Cancellation of Voluntary Deduction Authorization - 403(b) TDA/Roth and 457(b)

Fee Remission Forms

Fee Remission Form

Retiree Fee Remission Form

Payroll

Payroll Forms Information

Direct Deposit Form

Federal W-4 Tax Form

State WH-4 Tax Form

12 Month Pay Option Authorization Form

Kronos Access Form

B-25 Individual Absence Report Faculty-Staff.pdf

B-77 Individual Absence Report-Other.pdf

2009 Payroll Calendar