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Employment Forms
Benefit Forms Educational Support Forms
Information Changes
Temporary Employment Forms
UM-Dearborn Student temporary packet
Temporary Employment packet
Also include with the above packets: Back to Top
Staff Employment Forms
Supplemental Appointment Information (Oath Form)
Employment Eligibility Verification I-9
Beneficiary Designation / Change
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Faculty Employment Forms
Appointment Request Form
Appointment Activity Record (AAR)
Faculty Personnel Record
Faculty Selection Criteria Form
Faculty Search Committee Affirmative Action Report
3-4 Month Summer Appointment
Authorization to Extend Offer
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Additional Employment Forms
Authorization for Criminal Records Check
Employment Eligibility Verification – I9
Federal W-4 also available online through Employee Business
Michigan W-4 also available online through Employee Business
Direct Deposit Authorization Form also available online through Employee Business
Budget Clearance Form
Position Description Form
Layoff and Termination Request
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Health & Retirement Benefits
Enrollment Forms for New Faculty and Staff Members
Medical Insurance Forms
Prescription Drug Plan Forms
Dental Plan Forms
Vision Plan Forms
Claim Forms
Life Insurance Forms
Expanded Long-Term Disability Forms
Flexible Spending Account Forms
Retirement Savings Plan Forms
457 (b) Forms
Graduate Student Forms
Same-Sex Domestic Partnership Forms
Benefits Enrollment / Change Forms
COBRA Forms
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Educational Support Forms
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Tuition Support Request Form - see SPG 201.69 for additional information
Dearborn Employee Dependent Tuition Scholarship Form - click here for additional information about the scholarship requirements
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Payroll
Federal Tax Withholding Form W-4 also available online through Employee Business
Michigan Tax Withholding Form W-4 also available online through Employee Business
Michigan City Tax Form
Direct Deposit Authorization Form also available online through Employee Business
US Mail Authorization Form
Request a copy of your W-2 available online through Employee Business
Please visit http://www.payroll.umich.edu/ for a comprehensive list of payroll forms.
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Address / Personal Data Change
Name and Home Address also available online through Employee Business
Work Address also available online through Employee Business
Degree Completion
Social Security and Citizenship Information
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HRRIS Forms
General HRRIS Forms
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OARS Access
System Access Link
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Performance Management
2007/2008: 2008/2009: - A new form will be introduced this summer (2008) and used for the 2008/2009 evaluations.
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Leave of Absence / Work~Connections Forms
Request for Leave of Absence
Injury or Illness Report Form
Health Care Provider Report
Authorization to Obtain Patient Information
Certification of Health Care Provider
Sabbatical Leave - Form J
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The University of Michigan
Dearborn Human Resources
1020 Administration Building
4901 Evergreen Road
Dearborn, MI 48128
Phone: 313-593-5190
Fax: 313-593-3568
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