Employee Injury

• Workers compensation letter
• Notice to employees
• Injury Report (Worker's Compensation)

Employment Forms

• W-4 (Employee's Withholding Certificate)
• I-9 (Employment Eligibility Verification)
• PA Earned Income Tax

Flexible Spending Accounts

• PayFlex Reimbursement Account Claim Form
• PayFlex Direct Deposit/Electronic Fund Transfer Authorization Form

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

• New Direct Deposit—Use to begin a new direct deposit
• Change Direct Deposit—Use to change an existing direct deposit
• NBA Credit Union Membership Application
• NBA Credit Union Authorization
• Charitable Gift Payroll Deduction Program

Pension (Retirement)

• First time enrollment
• Account maintenance

Traveler's Insurance

• Business Travel

Tuition Benefit

• Tuition Benefit Form

Miscellaneous

• Employee Release to Obtain a Motor Vehicle Report
• Update your Directory Information
• RideEco
• Change of Address
• Name Change

Visit the Business Office for additional forms.