ABSENCE FORMS

• Leave of Absence Request Form

• Short Term Disability Form

• Time Off Request Form

ADOPTION FORMS

• Adoption Expense Reimbursement Form

BENEFIT FORMS/INSTRUCTIONS

BENEFIT ENROLLMENT, ONLINE INSTRUCTIONS

• Online Benefit Enrollment, Vibe, New Hires (FT) & Life Status Change

AFLAC FORMS

• Accident Injury Claim Form

• Cancer Wellness Form

• Aflac Direct Deposit Instructions

DISABILITY FORMS

• Short Term Disability Form 

FLEXIBLE SPENDING ACCOUNTS, iSOLVED

• Debit Card Banking Process, FSA 

• Expenses, Eligible/Ineligible 

• Instructions, Infinisource Consumer Portal

• Reimbursement Form, FSA

MEDICAL FORMS/INSTRUCTIONS

• Blue Cross/Blue Shield Medical Claim Form

• Blue Cross/Blue Shield Drug Claim Form

• BCN Primary Care Physician Selection Form

• Instructions, Vibe Online Benefit Enrollment,  New Hires (FT) & Life Status Change

DEDUCTION FORMS

• 403(b) Salary Reduction Agreement, Ave Maria University

DONATION FORMS

• Founders, Ave Maria University, Payroll Deduction Authorization

• Guild, Ave Maria Communications, Payroll Deduction Authorization

EDUCATIONAL ASSISTANCE FORMS

• • Educational Assistance Application

  • Tuition Reimbursement Form

EMPLOYEE CHANGE FORMS

• Employee Profile Revised Form

• New Hire Salary Change Form Revised 2/2023

EMPLOYER FORMS

NEW HIRE FORMS

• • Application for Employment (generic form) 

  • Compliance Posters, Employee Acknowledgment (for all employees not located at Domino's Farms Office Park)  Revised form

  • Concentra Testing

  • Direct Deposit Form

  • Employee Profile Revised Form

  • Handbook, Employee Acknowledgement, Ave Maria Art Gallery, Communications, Foundation, Legatus and Thomas More  Revised form

  • Handbook, Employee Acknowledgement, 2020 Domino's Farms and Domino's Farms Petting Farm  Revised form

  • I-9, Employment Eligibility Verification 

  • Job Description (provided by employer)

  • New Hire Salary Change Form, 2023 Revised form

  • W-4, Federal Withholding 2023

  • W-4, State of Michigan Withholding 2023

SEPARATION FORMS

• • AMF,Exit Interview Revised form 2021

  • DFC, Exit Interview Revised form 2021

  • Separation Notice

  • Separation Checklist

DISCIPLINARY FORMS

• • Employee Performance Notice

EXPENSE REIMBURSEMENT FORMS

• • Expense Reimbursement Form

JP&R FORMS

• •  JP&R template,  Excel format

LEAVE OF ABSENCE FORMS*

*Located under Absence Forms

MEDICAL BENEFITS FORMS*

*Located under BENEFITS

NAME CHANGE FORMS

• Name Change Form

NEW HIRE FORMS*

*Located under Employer Forms

RETIREMENT PLAN FORMS

• • Beneficiary Designation Form 401(k)

  • Beneficiary Designation Form, 403(b)

  • Acknowledgement, Receipt of 401(k) Retirement Materials, 2020

  • 403(b) Salary Reduction Agreement, Ave Maria University

  •  TIAA-CREF Online Instructions 403 (b), Ave Maria University

  •  Inbound Rollover Form 

TAX FORMS

• • W-4, Federal Withholding 2023

  • W-4, State of Michigan Withholding 2023

TIME OFF FORMS*

*Located under Absence Forms

WELLNESS FORMS

  Marquee Annual Physical Form

WORKER'S COMPENSATION FORMS

ALL STATES EXCEPT CALIFORNIA AND OHIO:

• WC AUTHORIZATION TO TREAT FORM, ALL STATES EXCEPT CALIFORNIA AND OHIO, CONCENTRA 

CALIFORNIA ONLY

• WC AUTHORIZATION TO TREAT FORM, CALIFORNIA ONLY, CONCENTRA 

OHIO ONLY   

• 80028128 OHIO WORKERS' COMPENSATION BUREAU (OHIO ONLY)  

If you have any questions regarding the forms on this site, please contact the Human Resources Department at 734.930.4542.