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Loyola University Chicago

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Pay & Holiday Calendar

2021 Pay and Holiday Calendar (PDF)
2022 Pay and Holiday Calendar (PDF)
Current Academic Calendars

Compensation

Resources

Performance Management

Key Forms

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
COVID-19 Request for Reasonable Accommodation (PDF)
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)

Hiring - New Employee

Hiring a Student Worker & Processing HR Paperwork
International: Office of International Students & Scholars
International: Nonresident Alien Compliance Information
International: Glacier for Hiring Managers Resource (PDF)
Register for Loyola Alert
Out of State Employee Information

Personnel Action

Personnel Action Form (PDF)
Student Workers - ePAF Login
- Student Workers: ePAF Request (PDF)

Retiree & Retirement

LUERP Pension Estimator
LUERP Beneficiary Form (PDF)
Medicare Request for Employment Information (PDF)
Retiree Health Reimbursement Account Enrollment Form (PDF)
Retiree Statement of Privileges Form (PDF)

Voluntary Self-Identification

Self Identification Form for Veterans (PDF)
Am I a Protected Veteran?
Disability (PDF)
OFCCP Self ID Video—Open Captioned
Requests for Reasonable Accommodation for Disability

Workers' Compensation

Limitations (PDF)
Report of Workplace Injury (Workers Comp) Form (PDF)
Workers' Compensation Policy and Information

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Office of Human Resources · 820 N. Michigan Ave., Chicago, IL 60611 · 312.915.6175 hr-wtc@luc.edu

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