Human Resources Forms

Tax Forms

• Federal Tax Form
• State Tax Form
• City Tax Form

General Forms

• Direct Deposit Form*
• Final Pay Beneficiary Designation Form*
• Employee Information Change Form*

Health Insurance Forms

• BCBS Plans*
• HAP Plans*
• Delta Dental*
• Heritage*

Family and Medical Leave Act Forms

• Family and Medical Leave Request*
• Rights and Responsibilities*
• Medical Certification for FMLA – Employee*
• Medical Certification for FMLA – Family Member*
• Medical Certification for FMLA – Maternity*
• Medical Certification for FMLA – Injured Service Member*
• Certification for Disabled Individuals over the age of 18 for Coverage under
  FMLA*
• Certification for a Qualifying Exigency*

Life Insurance, Short Term Disability, Long Term Disability, Accidental Death Forms

• Enrollment Form*
• Change Form*

Tuition Reimbursement Forms

• Prior Approval Form*
• Reimbursement Request Form*

Voluntary Life Insurance Form

• Voluntary Life Insurance Form*

Please click the internal documents card below for instructions on how to access the Human Resources forms.