Employee Forms & Benefits
Who to contact when you have a question...
Employee/Retiree Health Insurance
Payroll
Personnel/Civil Service & Support Staff Applications
Employee Forms
- Declination of Health Insurance - CSEA
- Declination of Health Insurance - PJTA
- Direct Deposit Form
- State Employee Withholding Form
- W-4 (2018)
- 403-B Plan Form
- Port Jervis Educational Foundation Payroll Deduction Form
- Coaches Salary Paid
- ERS - Address Change Form
- TRS - Address Change Form
Preferred Group - Unreimbursed Medical
- FLEXible Benefit Plan Brochure
- FSA Enrollment Form
- FLEX Plan Reimbursement Voucher
- PrePaid Benefit Card Enrollment Form
