Embedded Files
PEDACKN
PEDACKN
A PEDACKN is a form that independent contractors sign to acknowledge that the service they are providing to us does not make them eligible for the OPERS retirement system. It is only required for individuals with whom the Department contracts for services. Companies and agencies do not need to complete the form. A copy can be found in the shared Google drive Fiscal Forms and Resources.
W-4
W-4
If you need to update your personal income tax deductions or home address, please complete a new W-4 and give it to the Fiscal Office and the County Auditor's Payroll Clerk. The most recent W-4 can be found on the IRS website or in the Google drive Fiscal Forms and Resources.
Health Insurance
Health Insurance
If you have a qualifying event and need to update your health insurance coverage, please complete a new CEBCO change request form. The most recent form is from 2015. You can find a copy of it in the Google drive Fiscal Forms and Resources.
W-2 / 1099 Income Statements
The County Auditor's office issues W-2 and 1099 statements. For employees, they are usually give to the fiscal office in January for distribution to employees. They mail the 1099s to the address on file. In both cases, it is important to keep both the fiscal office and the auditor's office updated if you change mailing addresses.
You can contact Trena Brooker in the County Auditor's office by dialing 2111 from the Health Department phone system or call 740-373-6623 ext 2111 or email her at tkbrooker@wcgov.org if you have any questions or need additional copies of either W-2s or 1099s.
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