New House Employee Payroll and Benefits Checklist 

Form Service Provider Notices or Reminders Check Here When Completed
Payroll Authorization Form (PAF) Payroll, Office of Finance, 263 CHOB x56514 To be appointed as an employee on the payroll for the U.S. House of Representatives, this form must be completed and signed by the Member of Congress.
Employee's withholding allowance certificate form W-4 Payroll, Office of Finance, 263 CHOB x56514 Form W-4, Federal Income Tax Withholding Authorization.
Substitute Form W-4 Payroll, Office of Finance, 263 CHOB x56514 Form authorizes federal and/or state income tax withholdings.
Employment Eligibility Verification (Form I-9) Payroll, Office of Finance, 263 CHOB x56514 Form I-9 must be certified and signed by the employing office. The employee must complete and sign section 1.
Oath of Office, Payroll and Benefits Information form Payroll, Office of Finance, 263 CHOB x56514 Front and back of form, including signature, MUST be completed before employee can be put on House Payroll. Form W-2 and earning statements will be sent to the address provided by the employee on this form.
Direct Deposit Form Payroll, Office of Finance, 263 CHOB x56514 The Direct Deposit Sign-Up Form must be approved and signed by the financial institution before submission to the Office of Finance. Claim or Payroll ID Number (Section 1, Letter "C") is employee SSN.
Savings Bond Form SBD-2090 Payroll, Office of Finance, 263 CHOB x56514 Form SBD - 2090 is to be completed and signed if you wish to purchase a savings bond through a payroll deduction.
Health Benefits Registration Form SF-2809 Personnel & Benefits, Human Resources, 263 CHOB X52450 Enrollments take effect on the first day of the pay period that begins after the Office of Personnel and Benefits receives your completed SF2809. Deadline for filing Health Benefits Form is 31 days from effective date of employment.
Election of Retirement Coverage Personnel & Benefits, Human Resources, 263 CHOB X52450 Civil Service Retirement Systems (CSRS) Employees Only
Life Insurance Election Form SF-2817 Personnel & Benefits, Human Resources, 263 CHOB X52450 New employees are automatically enrolled in Basic Life Insurance. If you do not want life insurance deductions you must submit a waiver. If you want basic and additional options you must submit Form SF2817 within 31 days of your date of employment. Rates are listed in the FEGLI booklet.
Certificate of Relationship/ Non-Relationship Payroll, Office of Finance, 263 CHOB x56514 House form certifying relationship / non-relationship to any current Member of Congress to be kept by Member. This form is not required in Finance.