Human Resources
Human Resources
Main 25
700 College Drive
Decorah, Iowa 52101
Phone: 563-387-1134
Fax: 563-387-1391
Forms
Bank Deposits
Faculty and staff direct deposit form
Tax Forms
2013 W2 Notice/Instructions for Employee
Additional Employment Forms
Employee Chosen Name Application
Faculty Parental Leave Request Form
MEP (TIAA Salary Deferral Agreement) Multiple Employer Plan Salary Deferral Agreement
Minors on Campus Training Workbook
Moving Expense Form for New Employees
Request to Hire Form (Word doc)
Staff Parental Leave Request Form
Temporary Employee Offer Worksheet
TIAA Rollover Form (to roll monies into your Luther account
2022-23 Part-Time Tuition Credit Application (faculty/staff taking a class)
Workers Compensation Reporting Worksheet
Health Care Forms
Delta Dental Enrollment/Change Form
Flexible Benefit Dependent Care Reimbursement Form
Flexible Benefit Health and Dependent Care Change Form
Flexible Benefit Medical Care Reimbursement Form
Flexible Benefit 2022 Enrollment Form
HSA Payroll Deduction Authorization
Health Claim Submission Form – UMR
Health Insurance Enrollment Form for 2022 (pdf)
Human Resources
Human Resources
Main 25
700 College Drive
Decorah, Iowa 52101
Phone: 563-387-1134
Fax: 563-387-1391