HR Forms

Forms for New Employees

• W-4 (.pdf)
• M-4 (.pdf)
• Foreign National Information Form (.pdf)

Benefit Forms

• Flexible Spending Account Brochure (.pdf)
• FSA Debit Card Brochure (.pdf)
• Flexible Spending Account Enrollment Form (.pdf)
• Medical FSA Reimbursement Request (.pdf)
• FSA Eligible Items as of 1-1-11 (.pdf)
• Dependent Care FSA Reimbursement Request (.pdf)
• Leave of Absence Request (.pdf)

Tuition Benefits

• SACHEM Application (.pdf)
• Summer 2013 Tuition Credit Application (.doc)

Performance Management & Performance-based Compensation

• Performance Plan (.doc)
• Professional Development Plan (.doc)
• Performance-based Bonus Nomination (.doc)

Wage & Salary Program Forms

• Employee Stipend & Additional Pay Request (.doc)
• Position Reclassification Request (.doc)

Other Internal Forms

• Accident Report (.doc)
• Exit Interview (.doc)
• Health Insurance Responsibility Disclosure (HIRD) Form (Benefit Eligible)(.pdf)
• Health Insurance Responsibility Disclosure (HIRD) Form (Non-Benefit Eligible)(.pdf)
   Label Request Form (.doc)
• Telecommuting Request Form (.pdf)