Forms
Employee Injury Report
Employment Forms
- W-4 (Employee's Withholding Certificate)
- I-9 (Employment Eligibility Verification)
- PA Earned Income Tax
Flexible Spending Accounts
- HealthNow Administrative Services Claim Form
- Group Name: Haverford College
- Group Number K26903
- Dependent Care Spending Account Eligible Expenses Brochure
- Medical Care Spending Account Eligible Expenses Brochure
Medical Insurance
- Benefit Election Form for Full-time Employees
- Benefit Election Form for Part-time Employees
- Future Scripts Mail Order Form
- Davis Vision Claim Form
- Personal Choice Out-of-Network Claim Form
- Keystone POS and HMO Self Referral Form
Payroll
- Direct Deposit (NEW) - Form to be used to begin a new direct deposit
- Direct Deposit (CHANGE) - Form to be used to change an existing direct deposit
- NBA Credit Union Membership Application
- NBA Credit Union Authorization
Pension (Retirement)
- Pension Election Form (College's Contribution)
- Salary Reduction Agreement (SRA) (Employee's Contribution)
Traveler's Insurance
Miscellaneous
- Employee Release to Obtain a Motor Vehicle Report
- Directory Update (Update your Directory Information)
- Transit Check
- Change of Address
Visit the Business Office for additional forms.