Payroll & Benefits Forms

Payroll Adjustment Notification

All payroll adjustment notifications, overpayment notifications, and pay stop requests should now be processed via the online Adjustment Notification Application (ANA).

• GC91 - Documentation of Payroll Overpayments charged to Sponsored Projects [updated: 6/16/15]

Award Payment Template

• Award Payment Template [updated: 3/9/15]

Authorization for Distribution of Payroll

All Campuses

• Authorization for Distribution of Payroll [updated: 4/21/04]

Miscellaneous Income

All Campuses

• Form 1099 MISC, Miscellaneous Income [updated: 10/03/14]

Request for Payment

All Campuses

• Request for Employee Payment [updated: 7/22/15]

Return Payroll Checks

All Campuses

• Return payroll checks to University Payroll [updated: 5/24/06]

Loss or Theft of Checks

All Campuses

• Affidavit of Loss or Theft of Check [updated: 4/13/07]

Revocation Card

All Campuses

• Revocation Card [updated: 11/19/03]

Voluntary Deduction Agreement Form

All Campuses

• Voluntary Deduction Agreement Form [updated: 8/15/07]

Foreign National Payment

All Campuses

• Foreign National Payment e-Form [new: 7/26/10]

  Use this form to submit payment requests for non-employment and non-travel expense reimbursements. The Foreign National Payment e-Form utilizes a new electronic approval. Please see these instructions  on how to set up your digital id.

• Foreign National Scholarship and Fellowship Payments [updated: 7/16/08]
  Use this form to aid in the process of selecting the correct payment option of scholarships and fellowships for nonresident alien students.

• Please see the Foreign Nationals Forms page for additional forms.

Tax Forms

Employee's Withholding Allowance Certificate

All Campuses

• Federal Form W-4, Employee's Withholding Allowance Certificate

  Used to change or update amount of federal tax withholding. This can be done via NESSIE unless exempt status is claimed.

• Illinois Department of Revenue Form IL-W-4, Employee's Illinois Withholding Allowance Certificate [updated: 12/22/03]

Employee's Wage and Tax Statement

All Campuses

• Federal Form W-2, Wage and Tax Statement [updated: 1/7/09]

  Sample of W-2 Wage statement that is mailed to each employee at year-end.

Request for Duplicate Tax Form (W-2, 1042-S and/or 1095-C)

All Campuses

• Request for Duplicate Tax Form (W-2, 1042-S and/or 1095-C) [updated: 12/20/16]

  This form is to request a duplicate of your Form W-2, Form 1042-S and/or 1095-C for a previous tax year only . To request a duplicate W-2 and/or 1042-S for the current tax year, please call the Reissue Call Center at 866-923-6767.  To request a duplicate 1095-C for the current tax year, please call University Payroll & Benefits Customer Service at:

• UIUC:  217-265-6363
• UIC:  312-996-7200(Phone Number requires dialing all 10-digits)
• UIS:  217-206-7144

Employee's Statement of Nonresidence in Illinois

All Campuses

• Illinois Department of Revenue Form IL-W-5-NR, Employee's Statement of Nonresidence in Illinois [updated: 12/22/03]

  Used to request withholding for states with reciprocal agreements with Illinois (Wisconsin, Kentucky, Iowa and Michigan).

Foreign Person's U.S. Source Income Subject to Withholding

All Campuses

• Form 1042-S, Foreign Person's U.S. Source Income Subject to Withholding

  Sample of statement sent to foreign national persons with earnings from the University of Illinois.

Employee Statement of Employer Provided Vehicle

All Campuses

• Employee Statement of Employer Provided Vehicle [updated: 10/27/15]

  To report usage of an employer provided vehicle for tax purposes.

Certification of Non-residence

• Certification of Non-residence in Illinois [updated: 12/6/11]

Last Updated: December 20, 2016