Employee Forms

Payroll

  1. Direct Deposit (PDF)
  2. Emergency Contact Information-Change of Address (PDF)
  3. I-9 Employment Verification (PDF)
  4. M-4 State Tax Withholding (PDF)
  5. Social Security Statement (SSA-1945) (PDF)
  6. W-4 Federal Tax Withholding (PDF)
  7. W-9 Request for Taxpayer ID Number (PDF)

Retirement

  1. Worcester Regional Retirement Beneficiary Form (PDF)
  2. Worcester Regional Retirement Enrollment Form (PDF)

Benefits

  1. Altus Dental Enrollment Form (PDF)
  2. Harvard Pilgrim Enrollment Form (PDF)
  3. HRA Claim Form (PDF)
  4. HRA Reimbursement (PDF)
  5. Insurance Opt-out (PDF)

New Hire

  1. New Employee Welcome Packet (PDF)

Group Insurance Commission

  1. Active Employees Form (PDF)
  2. Dependent Enrollment Form (PDF)
  3. Employment Status Change Form (PDF)
  4. Medicare Enrolled Employees Form (PDF)