Benefits Forms
Employee Forms
Direct Deposit Authorization
Used to establish direct deposit of payroll checks into an employee's bank account. You may fill out this form online prior to printing.
Dependent Benefit Enrollment
Used to add or drop dependents from insurance coverage due to a qualified family status change outside of the annual enrollment period (July of each year). You may fill out this form online prior to printing.
Beneficiary Designation
Used to designate the beneficiary for Basic Life, Optional Life, and Accidental Death & Dismemberment Insurance policies. You may fill out this form online prior to printing.
Benefit Change Form
Used to change health, dental, optional life, dependent life, accidental death & dismemberment, long-term disability, or long-term care coverage in the event of a qualified family status change outside of the annual enrollment period (July of each year). You may fill out this form online prior to printing.
Sick Leave Pool Standard Operating Procedure (For more information regarding Sick Leave Pool eligibility, please contact Tina Pennington in the Human Resources office at 409-740-4534)
Retirement Forms
TDA - Tax Deferred Annuity - Salary Reduction Agreement (HR17)
ORP - Optional Retirement Plan - Salary Reduction Acknowledgement/change of Vendor (HR14)
Tax-Deferred Account Maximum Contribution Limit Worksheet (HR10)
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