484
This form is used for requesting a voluntary cash out of a small balance from the NC 457 Plan in North Carolina.
This form is used for enrolling in employee benefits in Stanislaus County, California.
This Form is used for making changes to your benefit elections in Miami-Dade County, Florida. It allows you to update your healthcare, retirement, and other benefits.
This Form is used for applying for a tobacco usage discount for benefits offered by the City of Houston, Texas.
This Form is used for enrolling in the Cobra healthcare program offered by the City of Mesa, Arizona.
This form is used for donating sick leave hours to a sick leave bank in Vermont.
This form is used for declaring termination premiums to the Pension Benefit Guaranty Corporation (PBGC).
This Form is used for collecting and updating employee information in the state of Colorado.
This form is used for requesting, authorizing, and reporting compensatory time, travel compensatory time, holiday premiums, and overtime.
This Form is used for Virginia small group employers to apply for coverage for their employees.
This document is used for enrolling or making changes to employee benefits in West Virginia.
This form is used for applying to be a donor in the Leave Transfer Program.