Town of Wilbraham, MA - Personnel Forms

Personnel Forms

Form	Use for
Flexible Benefits Plan Election Form and Compensation Reduction Agreement	Enroll in the Section 125 Flexible Benefits Plan and agree to paycheck deductions on a pre-tax basis
FMLA Notice of Eligibility and Rights and Responsibilities	Notice you receive from the town if your leave may be protected by FMLA
FMLA Designation Notice	Notice that your leave is protected under FMLA
FMLA Certification of employee’s serious health condition	Certify your own medical leave is protected under the FMLA
FMLA Certification of family member’s serious health condition	Certify your family member's condition as protected under the FMLA
FMLA Certification of qualifying exigency for military family leave	Request for military FMLA
FMLA Certification for serious illness of covered service member for military family leave	Certify serious medical condition of covered service member
Employee Contact Information	Change your address, phone and other contact information
W-4 (2010)	Determine federal income tax withholdings
I-9 (Employment Eligibility Verification)	Document eligibility to work in the US
Direct Deposit	Have your paycheck deposited into one or several accounts (submit to the Town Accountant)
OBRA Application	Application for alternative retirement plan for seasonal, temporary and part time employees

Town of Wilbraham