Payroll, Health Insurance and other related forms

Request for Absence

Health

Health Insurance Claim form (Empire Blue Cross) (2 pages)

Employee Benefits Enrollment and Change form

Merck Medco Home Delivery Pharmacy Service Order form

Flex-Plan Reimbursement forms Healthcare Reimbursement Form Dependent Care Reimbursement Form

Payroll Services

Flexible Benefit Plan Enrollment form

- Election for Health Care Spending Account

- Election for Dependent Care Spending Account

Aflac Salary Redirection Agreement form

Direct Deposit Authorization form

OMNI 403b Flex form (2 pages)

OMNI 457 Flex form (2 pages)

W-4 2007 Employee's Withholding Allowance Certificate - Federal form (2 pages)

IT 2104 (2007) Employee's Withholding allowance Certificate - State form (2 pages)

Payroll Time Sheet form

Building Use

Request For Use Of Facilities During School Hours

Request For Use Of School Facilities After School Hours

Conference/Travel Reimbursement form