Employee Forms

Full Time Employees

FormForm Description
W-4Federal Tax Withholding Form
M-4State Tax Withholding Form
SSA-1945Statement Concerning Social Security
Direct Deposit AuthorizationDirect Deposit Authorization
I-9I-9 Form
Norfolk County Enrollment FormEnrollment Form
Norfolk County Beneficiary FormBeneficiary Form
Harvard Pilgrim Health Care HMO Plan SummarySummary of Benefit Coverages
Harvard Pilgrim Health Care PPO Plan SummarySummary of Benefit Coverages
Harvard Pilgrim Enrollment/Change FormEnrollment Form
Delta Dental Summary of BenefitsSummary of Benefits
Delta Dental Enrollment FormEnrollment Form
Flexible Spending Enrollment FormEnrollment Form
Disability BrochureSummary of Benefits 

Part Time Employees

FormForm Description
W-4Federal Tax Withholding Form
M-4State Tax Withholding Form
SSA-1945Statement Concerning Social Security
Direct Deposit AuthorizationDirect Deposit Authorization
I-9I-9 Form
OBRA EnrollmentEnrollment Form