Back to Benefits Homepage

Please contact HR if you have any questions x2049

1. Leave

2. I-9

3. W-4

4. Name & Address Change

5. Direct Deposit Request

6. IT Access Form

Leave Form    

ALL ORIGINAL SIGNATURES MUST BE ON FORM AND SUBMITTED TO HR IN ORDER FOR THE LEAVE TO BE VALID.

All Annual and Personal Leave must be taken before June 30th of each year.

If you have questions or need your remaining balance please call x2049

Note: This form type able and printable.

I-9 Form  

Please complete section 1 only.  Do not forget to submit 2 forms of ID (indicated on the second page what is acceptable) and put your current status and sign and date.

Note: This form type able and printable..

W-4 Form  

Use this form to change your federal deductions (i.e. Number of dependents claimed, exemption, additional deductions)

If you have questions please call x2049

Note: This form type able and printable.

Name & Address Change Form    

Please fill out all applicable areas.

If changing your name please submit social security card showing your new name.

If you have questions please call x2049

Note: Name change request will not be processed without the above document.

Direct Deposit Request Form  

Please make your selection.  If changing or adding, please submit one of the following:

• Voided Check

• Account information on bank letter head to indicate how to route deposit into your checking and/or savings account(s)

If you are cancelling your direct deposit, please contact payroll BEFORE you close your account.

If you have any questions contact x2049 or x2050 (faculty) or x2086 (staff)

Note: Direct deposit takes one full payroll cycle to become effective.

IT Access Form  

If you are changing or requesting access, please fill out all applicable areas.  All forms requiring your initials are signatures are to be returned to the Office of Human Resources Management.  Please ensure that the department head signs in the appropriate place on the form.

If you have questions please call x2049

Note: This form type able and printable.

Last Update: May 11, 2006

Date of last update: 05/11/2006

Questions? Please contact Ms. Cathy Washington
washinca@cookman.edu
(386) 481-2540

640 Mary McLeod Bethune Blvd., Daytona Beach, FL 32114-3099 (386) 481-2000
Contact the College Webmaster