Miscellaneous Forms for Current City Employees:

Authorization for Automatic Deposit
Educational Incentive Plan Request Form
Hartford 457 Deferred Comp Contribution Change Form
Hartford 457 Def Comp Beneficiary/Name & Address Change Form
Your current and future allocations may be changed online at Hartford

RHS Enrollment/Change Form
ICMA-RC 457 Deferred Comp Change Form

ICMA-RC 457 Def Comp Beneficiary/Name Change Form
Your current and future allocations may be changed online at ICMA-RC

Injury Reporting Instructions and corresponding forms

HSA Salary Redirection Authorization

MERS Name and Address Change Form

MERS Beneficiary Change Form (2 pages)

Section 125 Plan - Dependent Care Claim Form
Section 125 Plan - Limited Purpose Health FSA Claim Form

W-4 Michigan Withholding Allowance Form

 
W-4 Federal Withholding Allowance Form

Insurance Change Forms:

Priority Health

Delta Dental

Employee Information:

Employee Assistance Program