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University of Connecticut Payroll Department

Forms

Click Here For Important Information Regarding Collection and Use of Social Security Numbers

SSN required on University employment forms: Federal tax regulations require the University of Connecticut Payroll Department to collect a social security number (SSN) from every employee who is paid compensation. Employee SSN’s are maintained and used by the University for payroll and benefits purposes, to verify employment history, and where required by law or for benefits purposes, to report the employee’s SSN on Federal and state agency forms. Except as mandated by law or as required for benefit purposes, the University will not disclose an employee's SSN to any person or organization outside the University without the employee’s prior consent. Failure to provide a SSN to the University of Connecticut on required Human Resources forms may result in the withdrawal of an offer of employment and/or the denial of benefits.

SSN required by third party form (such as benefit form): At times the University of Connecticut may provide University employees with forms on behalf of benefit providers and other organizations. Many of these forms require you to provide your social security number (SSN). As private companies it is within their rights to require you to provide your SSN in order to provide the requested service. These services typically include but are not limited to health and life insurance, retirement benefits, and employment verification. In addition, many State and Federal forms will also request your SSN. These forms may include, but are not limited to: tax and other compensation-related forms, background check forms for security sensitive positions, immigration forms, and forms for other government services. If you feel one of these third parties has misused your SSN, your first recourse is to contact the third party directly.

FORM AVAILABLE FORMAT
Application For Refund Retiree Health Contributions (CO-1301) WORD
Authorization To Send Checks Via Campus Mail PDF
Cell Phone Stipend Wireless Stipend Website
Direct Deposit Authorization Agreement PDF
Direct Deposit Authorization Agreement (Secondary) PDF
Dual Employment Form PDF
FOCUS Agreement PDF
Foreign National Information Form PDF
Form I-9 PDF
Form W-9 PDF
Payroll Authorization (Classified & Unclassified) (New PA Instructions) XLSX
Personal Information Change Form WORD
Retiree Health Fund Forms Comptroller's Website
Request for Reimbursement of Moving Expenses &
Moving Expense Reimbursement Form (ME-13)
PDF
Request for Reimbursement of Recruitment Expenses &
Recruitment Expense Reimbursement Form (RE-13)
PDF
Special Payroll Authorization PDF or XLS
Student Payroll Authorization Agreement PDF
Student Payroll SICK Time Record PDF
Student Payroll Time Report Sheet PDF
TAS Subsidiary Workflow Designation Form WORD
TAS Workflow Designation Form WORD
Time Card Correction Form PDF
UCPEA Compensatory Time Accrual Request Form PDF
UCPEA Compensatory Time Payment Authorization Form PDF
W-4 Form (Federal) PDF
W4 Form (CT) PDF
Workers' Compensation - DAS First Report of Injury Form (WC207) PDF
Workers' Compensation - Filing Status and Exemption Form (1A) PDF
Workers' Compensation - Mileage Worksheet for Medical Treatment PDF