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Benefits and Payroll Forms

Onboarding and Notification of Employment Status

In accordance with Administrative Rule 5.1 (C) the Notification of Employment Status form should be completed and uploaded at least two weeks in advance of an appointment, termination or change in employment status. This will help our office meet rigid payroll and benefit deadlines and ensure timely processing of payroll checks and benefit elections.

Please note that all sections of the payroll form must be completed, and the completed form must be submitted using the secure document uploader on the Indiana Courts Portal. In addition, all newly elected and appointed officials should submit a copy of their social security card and driver’s license.

Judges who are eligible for a county supplement should be prepared to upload a letter from their county auditor that certifies eligibility and the annual amount they are entitled to.

Notification of Employment Status Form


Additional Forms

Claims for Services as a Senior Judge

Claims for Service as a Special Judge

Prison/Mental Health Facility Population Verification Form


Important Links

Indiana State Personnel Benefits – View state benefit plan options and rates.

Log in to People Soft HR – View/update personal payroll and benefits information.

Benefit Effective Dates – Dates for new hires, terms, and qualifying life event changes.

Pay Chart – View paydays, benefit effective dates and benefit termination information.

Invest in Your Health - Rewards program for preventive care and improving your health and wellness.


Tax Withholding Forms

W4 Federal Withholding Form

WH-4 State Withholding Form


Contact

Valerie Brooks
Benefits Manager/Fiscal Officer
Office of Judicial Administration
Phone: 317-234-1874
Email: Valerie.Brooks@courts.in.gov or INJP-Payroll@courts.in.gov

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