Forms A-Z

A
Alternate Work Schedule Agreement   

B
 Beneficiary Designation (CalPERS)  
Beneficiary Designation (Cigna Group Insurance)   
 Benefit - Proof of Other Coverage    
  
C

 Catastrophic Time Donation Form 
Cell Phone Stipend Certification  
Certification of Health Care Provider (FMLA)   

D

Declaration of Domestic Partnership  
Direct Deposit  
Disability Insurance (Short Term) Claim Form  
Disability Insurance (Short Term) Disclosure Authorization  
Disability Insurance (Short Term) Medical Request Form  
Disability Insurance (Short Term) Physician Statement Form  
Disability Insurance (Short Term) Withholding From Sick Pay (W-4S)   

E
Employee Benefit Change Form - Dental  
Employee Benefit Change Form - Medical  
Employee Benefit Change Form - Vision  
Employee Information Change Form
Employee Emergency Contact Information  
Employee Request for Family or Medical Leave (FMLA)  
Employment Application   
Evaluation Form (T.E.A.)  
Exit Interview Questionnaire  

F 
Flexible Spending Account Reimbursement Voucher 

I
ICMA - Loan Program Brochure  
ICMA-RC 457 Investment Options (2015)
ICMA - RC 457 Deferred Compensation Plan Amount of Deferral Change Form  
ICMA - RC 457 Deferred Compensation Plan Employee Enrollment Form  
ID Badge Request Form  

L
Los Gatos Town Employee Foundation (LGTEF) Enrollment Form    
 
O
  
P
Power of Attorney (CalPERS)
 
   
T
TEA Evaluation Form  
Tuition Reimbursement Request Form   

W

W4 - Employee's Withholding Allowance 2016 
Worker's Comp Form (DWC-1)  
Worker's Comp Injury/Incident Investigation Report  
Worker's Comp Instructions for Employees  
Worker's Comp Instructions for Supervisors  
Workers Comp Medical Facilities  
Worker's Comp Medical Referral Form 
Worker's Comp Refusal of Treatment Form