Employee Forms

Payroll

  1. Direct Deposit (PDF)
  2. Emergency Contact Information-Change of Address (PDF)
  3. i-9 2023
  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. HPI -EnrollChangeForm_Med_Member_Form (1)
  2. Altus Dental-vision_Enrollment Form 23
  3. Altus Dental Enrollment Form (PDF)
  4. Harvard Pilgrim Enrollment Form (PDF)
  5. HRA Claim Form (PDF)
  6. HRA Reimbursement (PDF)
  7. Insurance Opt-out (PDF)

New Hire

  1. New Employee Welcome Packet (PDF)