Employee Forms

The following forms are provided as a service to employees. They may be printed and complete as required. Each form will be downloaded to your computer and requires Adobe Acrobat Reader or Preview to open.

Health Insurance Forms

Healthchoice Claim Form

Insurance Change Form

Insurance Enrollment

Insurance Termination Form

2005 Option Period Change/Enrollment Form

OSEEGIB Beneficiary Form

OSEEGIB Life Insurance Application

Student Status Form

American Fidelity Forms

American Fidelity Physician Claims

American Fidelity Salary Protection Claim Form

Dependent Day Care Provider Acknowledgement

Felixible Benefit Direct Deposit

Felxible Benefit Plan Expense Reimbursement Voucher

Cancer Benefit Claim Form

Family Medical Leave Forms

Certification of Health Care Provider

Employee Leave Request

Employer Response

Personnel Forms

Additional Tax Withholdings Form

Payroll Direct Deposit Form

Sick Leave Sharing

Teacher's Retirment Personal Data Form

Transfer Request Form

W4 (2004)

Worker's Compensation Claim Forms

Authorization for Release of Medical Records

Election Form

Employee Report

Medical Care Authorization Form

Report of Occupational Injury

Witness Co-Worker's Statement