UW Benefits Forms and Publications
- This page contains a list of miscellaneous forms and publications. Navigate the right side bar to find forms and publications specific to retirement and insurances.
- Unless otherwise noted on the form, please send completed documents to the UW Benefits Office, Box 359556. (We cannot accept enrollment forms sent by fax or email attachment.)
- If you prefer to hand-deliver documents or send them through U.S. mail, read these directions.
- Read the form carefully to see whether additional documentation is required.
- Be sure to make copies of documents for your records before submitting them as we cannot make copies for you.
- If you cannot find a form or publication on this page or through one of the links shown at right, contact email@example.com. One of our support team will respond to your request within 2-3 business days.
Authorization for Direct Deposit
for Direct Deposit – For PERS, LEOFF or TRS retirees only: Use this form for all retirement benefit payments from DRS.
City of Seattle Domestic Partnership Registration
||City of Seattle Domestic
Partnership Registration – This is an application form to voluntarily register a domestic partnership with the City of Seattle.
Childcare Waitlist Application
||Childcare Waitlist Application – Use this application to be placed on a wait list for UW Children's Centers.
|Children's Centers Payroll Deduction/Termination Agreement
||For UW faculty and staff with children enrolled at UW Children’s centers at Harborview Medical Center, West Campus, or Radford Court. Complete this Payroll Deduction form and return it to the Benefits Office.
Dependent Care Assistance Program (DCAP)
DCAP enrollment is effective for one tax year only, and does not automatically renew from year to year. If you wish to participate in next year's DCAP, you must enroll or re-enroll during open enrollment, November 1-30.
Mail Enrollment/Change forms to:
UW Benefits Office, Box 359556
Mail or fax all other forms directly to:
Navia Benefit Solutions
PO Box 53250
Bellevue, WA 98015-3250
Fax to 866-535-9227
Pre-Tax Transportation Deduction Waiver
Transportation Deduction Waiver to waive your participation in this pre-tax plan, complete this form and mail to the Benefits Office.
Section 125 Waiver
||Premium Payment Plan Election/Change form (formerly the Section 125 Medical Plan Waiver form) – Read about the Section
125 Plan before deciding whether to waive participation in the state-sponsored Benefits Contribution Plan.
UW Combined Fund Drive
||UW Combined Fund Drive Donation Form
Contact us if you cannot find a form or publication on this page or through one of the links shown at right. To report a web problems, contact firstname.lastname@example.org.