Forms
Always use Loyola Secure Transfer to send Human Resources any forms that contain your personal and sensitive information. More about Loyola Secure Transfer can be found here.
Note: Most Human Resources' online forms require Adobe Acrobat Reader. Click here to download Adobe Acrobat Reader.
- 1095-C Request Form (PDF)
- 1095-C Form
- Adoption Assistance Program Reimbursement Form (PDF)
- Evidence of Insurability (EOI Form) (PDF)
- Legally Domiciled Adult (PDF)
- Group Life Conversion Application (PDF)
- Term Life Insurance Portability Request (PDF)
- Reliance Standard Accident Claim Form (PDF)
- Reliance Standard Critical Illness Claim Form (PDF)
- University Assisted Housing Program Application
- Wellness Benefit Claim Form - Accident and Critical Illness Insurance (PDF)
- WW® Reimbursement Form (PDF)
- Change of Address
- Or if no longer employed, e-mail hr-payroll-processing@luc.edu)
- Change of Name (PDF)
- Confidentiality Agreement (PDF)
- Conflict of Interest Disclosure Policy
- Medical Certification for Vaccine Form (PDF)
- Vaccine Exemption Form (PDF)
- Direct Deposit Change
- Disciplinary Report of Conference (PDF)
- Fitness for Duty Medical Authorization Form (PDF)
- Giving to Loyola - Payroll Deduction Form
- Annual Staff Performance Review (Word)
- Federal I-9 Employment Eligibility Form Instructions (PDF)
- Federal I-9 Employment Eligibility Form (PDF)
- Federal I-9 Employment Eligibility Form (Fillable PDF)
- Federal I-9 Supplemental Form(PDF)
- Federal W-4 Tax Withholding Change
- Federal W-4 Form (PDF)
- Illinois Dept. of Revenue-Electronic Filing
- Illinois W-4 Form (PDF)
- Other State & Local Witholding Forms
- Statement of Nonresidence in Illinois (IL-W-5-NR) (PDF)
