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Employment Application

Accounting & Payroll

• A/P Check Request
• Mileage Reimbursement
• Expense Report
• Time Off Request
• Direct Deposit Authorization
• Direct Deposit Cancellation
• LA State Tax Withholding
• MO State Tax Withholding
• Federal Tax Withholding (W-4 form)
• Payroll or Employee Status Change (Address)
• Christmas Club Savings Account Authorization
  

Benefits

• 2008 Annual Enrollment - EMPLOYEES RECEIVED A 2008 OPEN ENROLLMENT BENEFIT ELECTION FORM. THIS FORM MUST BE COMPLETED AND RETURNED BY DECEMBER 3, 2007, ALONG WITH ALL ADDITIONAL BENEFIT FORMS REQUIRED IF ENROLLING IN A NEW BENEFIT OR MAKING CHANGES)
• 2008 Benefits Summary
• 2008 Health & Rx Insurance
  (enrollment form and any changes)
• Dependent Certification
  (only complete if requested)
• Health Savings Account Authorization
  (only complete if electing BlueSaver plan and would like to open an HSA)
• Authorization Delegate Form
  
• Dental and/or Vision Insurance
  (enrollment form)
• Vision Plan Outline
• Dental Plan Outline
• LTD & ADD and/or Life Insurance
  (enrollment / change form)
• Change of Beneficiary Request
• Colonial Optional Insurance
  (contact information)
• 401k Retirement Plan
  (plan information and contact information)
• 401k Beneficiary Change Form

New Hire

• New Hire Checklist
• Employment Application
• Confidentiality and Security
• Employee Handbook Acknowledgement
• I-9, Employment Eligibility Verification
• LA State Tax Withholding
  (Louisiana Staff Only)
• MO State Tax Withholding
  (Missouri Staff Only)
• Federal Tax Withholding
• Paycheck Protocol
• Workmen's Compensation Questionnaire
• Hepatitis B Vaccine
• Credit & Background Check Authorization
• Per Diem Acknowledgement
• Direct Deposit Authorization
• Vehicle Responsibility Statement
  (Only if driving for business)

Management ONLY

• Payroll / Status Change
• Employee Incident Report
• Patient & Visitor Report
• Performance Appraisal
• Record of Conference
• Family Medical Leave
• Workmen's Compensation