DOW-R Forms -

All new hires (Notice of New Hire form only),

Benefit-eligible employee forms, and

Benefit-eligible employee terminations

For all new hires and benefit-eligible employee terminations, location should use online link in Dropbox to complete Form 001; if you do not have the link, contact benefits@dowr.org.

**These and additional informational forms are also under each section of the benefit tabs.

• Notice of New Employee Hire/Increase Hours/Termination/Reduce Hours Form - PDF (please use online link)
• Notice of New Employee Hire/Increase Hours/Termination/Reduce Hours Form - Word (please use online link)


• New Hire Employee Benefits Checklist - with links
• Form I-9 Employment Eligibility Verification. Continue to use this edition until the IRS revises it.
• Form I-9 (Instructions only)
• Form W-4 for 2024
• Form W-4MN - Please Note: All employees who complete a 2024 IRS W-4 form must complete the W-4MN.
• Form: Minnesota New Hire

Termination Notice Forms - used for only benefit-eligible terminating employees.

• Notice of New Employee Hire/Increase Hours/Termination/Reduce Hours Form - PDF (please use online link)
• Notice of New Employee Hire/Increase Hours/Termination/Reduce Hours Form - Word (please use online link)
• Terminating Employee Benefits Checklist
• Information for Terminating Employees Alerus - COBRA
• Information for Terminating Employees - Lincoln Retirement Plan

Medical/Dental Insurance Forms

• Form A-1: Enrollment/Change/Cancel/Waive Group Coverage
• Form A-2 Waive Only: Waive Group Coverage for new hires or open enrollment (Use form A-1 for cancelling insurance)
• Directions for Health Plan Participation and Forms

Life, AD&D, and LTD Insurance Forms

• Form: Basic Group Life Insurance , LTD and AD&D Enrollment Form B-1
• Long-Term Disability Insurance Claim Form - call Diocese - Benefits for information
• Directions for Term Life Insurance and Long Term Disability (LTD) Insurance Participation and Form
• Directions for Accidental Death and Dismemberment (ADD) Insurance Participation and Form

Lay Employees Retirement Plan Forms

• Form: Salary Reduction Agreement:  Form C-2
• Directions for 403b Lay Employees Retirement Plan Participation and Form

Flexible Spending Accounts Forms

• Form: FSA Enrollment (1/1/2023 - 12/31/2023) Form D-2
• Form: Status Change Form (Qualifying Event)
• Directions for Flexible Benefits Plan Participation and Forms

Supplemental Life Insurance Forms

• Form: Supplemental Life - Term Life Insurance Enrollment: Form E-1
• Form: Evidence of Insurability (EOB) Form - Email benefits for online form
• Directions for Supplemental Life Insurance Plan Participation and Forms

Family Medical Leave Forms

• Certification of Health Care Provider for Employee's Serious Health Condition
• Certification of Health Care Provider for Family Member's Serious Health Condition