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	Payroll Schedules
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	Contact Departments

	Insurance Policies
	Flex
	Deferred Comp
	Retirement
	YMCA

	W-4
	Address Change
	Direct Deposit (Enrollment)
	Direct Deposit (Change)
	Employment Changes

To View and Print Forms
These forms are in the Adobe Acrobat (pdf) format.

In order to view or print the forms, you must first have the Acrobat Reader installed on your machine. (We recommend version 6.0).

Should you need the reader, we have provided a link below to obtain the free program directly from the Adobe website.
INSTALL ADOBE ACROBAT

Vanderburgh County Payroll - Forms Available

Note: To print the following forms, be sure to use the "Print & Reset" button at the bottom of the form. If you do not use either the "Reset" or "Print & Reset" button, then your data will appear for the next person that uses the form.

W-4

This form is used to change your federal filing or exemption status with payroll. Since a signature is required on this form, the W-4 form needs to be printed and sent back to the Bookkeeping Department of the Auditor's Office. Use the link to the left to access the W-4 form.

Address Change

The form provided on this page will only change your address with payroll. When you send this form to the Bookkeeping Department of the Auditor's Office, you still need to change your address with:

your insurance plans
and your retirement plan.

Use the Insurance Policies link under Benefits (left navigation bar) to access Anthem or Welborn HMO to change your address with your health insurance. It can also be used to access the Dental and Vision plans.

Use the Retirement link under Benefits (left navigation bar) to access P.E.R.F. to change your address for your retirement plan. If you are a Sheriff's Deputy, under the Sheriff's Retirement Plan, you need to contact Steve Woodall, Sheriff's Pension Secretary.

Direct Deposit Enrollment

The Direct Deposit Enrollment form must be printed and signed before returning to Charlene Timmons in the Bookkeeping Department of the Auditor's Office. Use the Direct Deposit (Enrollment) link to the left to enroll for direct deposit. This will remain in effect until Vanderburgh County has received written notification of its termination.

Direct Deposit Change

The Direct Deposit Change form must be printed and signed before returning to Charlene Timmons in the Bookkeeping Department of the Auditor's Office. Use the Direct Deposit (Change) link to the left to change or cancel your direct deposit.

Employment Changes

The Employment Changes form is to be used by Vanderburgh County Department heads to submit to the Commissioners for approval. The form must be printed and signed by the Office Holder before returning to Gloria Leach in the Bookkeeping Department of the Auditor's Office. To be brought before the Tuesday Commission meeting, the form should be turned in to Gloria before 12:00 Noon on the Friday preceding the meeting. Use the Employment Changes link to the left to access the form.

Any comments or questions, email a contact.