Ohio Department of Rehabilitation and Correction New Employee Forms

How to complete Employee Forms

Employee Withholding Allowance Certificate (Form W4)

Employee Withholding Exemption Certificate (Form IT-4)

Address Change/Determination of Municipal Tax Liability

Employee Identification Card Request (DRC1687)

Emergency Information Form (DRC1758)

Employment Eligibility Verification (Form I-9) - provide requested documentation on first day

Statement concerning your employment in a job not covered by Social Security

Medical Benefits Enrollment/Change form (ADM4717) - can also process electronically via Benefits

Prudential Insurance Co. of America - exempt supplemental life insurance enrollment/beneficiary designation

Prudential Insurance Co. of America - bargaining union supplemental life insurance enrollment/beneficiary designation

WageWorks - Flexible Spending Account Enrollment

Physician's Statement (DRC1481)

Staff Nexus (DRC1500)