Forms

EMPLOYMENT

• Direct Deposit
• I-9
• Name & Address Change Form
• Overtime Authorization Form
• Supervisor Checklist
• Weekly Temporary Timesheet
• W-4
• M-4
  

BENEFITS

• Accommodation Request Form
• Accommodation Request Medical Statement
• Benefits Enrollment Form
• Leave of Absence Application
• Leave of Absence Medical Certification
• Tax Dependent Affidavit
  

Health

• Harvard Pilgrim Fitness Reimbursement Form
• Harvard Pilgrim POS Claim Form
• Mail-order Prescription Form
• HIRD Form - Eligible for Group Plan
• HIRD Form - Not Eligible for Group Plan
  

Flexible Spending

• Flexible Spending Claim Form

Retirement

• 403(b) Salary Reduction Agreement

Summary Plan Description

• 403(b) Summary Annual Report
• 403 (b) Summary Plan Description
• Welfare Summary Annual Report
• Welfare Summary Plan Description

Tuition

• Tuition Waiver Form (available in Office of HR/AA)