Documents and Forms

In an effort to streamline your hire process, please complete the following forms BEFORE coming to your New Hire Benefits Meeting. 

 

Attachments in PDF:

• Benefit Enrollment and Change Form

  Use this form to enroll into Health, Dental, Vision and Optional Plans.

• Healthcare Bonus Waiver Program Election Form

  Use this form to enroll into the Healthcare Bonus Waiver Program

• State Withholding

  Use this form to elect your State Withholdings

• W-4

  Use this form to elect your Federal Withholdings

• I-9

  This form is to verify your eligibility to work.

• CalPERS Reciprocity

  This form allows the County to notify CalPERS if you were a member of another retirement system so they can determine your appropriate CalPERS tier.

• Equal Opportunity Survey

  This survey is for data purposes only.

• Oath of Office

  This form is to recite and sign at the time of your hire.

• Outside Employment Form

  This form is to notify us of any other employment you have.

• CalPERS​​ Beneficiary Designation

  This form is to designate your CalPERS beneficiaries.

• Predesi​gnation of Personal Physician​

  This form is to designate your primary physician incase of an injury.

• Direct Deposit Authorization

  This form is a mandatory direct deposit election form.

• Final Warrant

  This form is to update your emergency contacts and Final Warrant beneficiary.

Additional Forms and Documents:

• Disability Insurance Pamphlet (PDF)

• Health Marketplace

• FMLA Policy (PDF)

• P&A Group FSA Plan Summary (PDF)

• P&A Group FSA Online Enrollment Instructions (PDF)