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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).

Award Payment Template

Authorization for Distribution of Payroll

All Campuses

Miscellaneous Income

All Campuses

Request for Payment

All Campuses

Return Payroll Checks

All Campuses

Loss or Theft of Checks

All Campuses

Revocation Card

All Campuses

Voluntary Deduction Agreement Form

All Campuses

Foreign National Payment

All Campuses

Tax Forms

Employee's Withholding Allowance Certificate

All Campuses

Employee's Wage and Tax Statement

All Campuses

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

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

All Campuses

Employee Statement of Employer Provided Vehicle

All Campuses

Certification of Non-residence

Last Updated: November 9, 2017

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