City of Kettering - Human Resources

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Human Resources

Frequently Used Forms

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Change of Address or Beneficiary (Form PE-9582)

Designation of Life Insurance Benefits

Direct Deposit Authorization Form

Educational Assistance Request (Form PE-3032)

Tuition Reimbursement for Future Years Request (Form PE-9578)

Tuition Advanced Reimbursement Request (Form PE-9579)

FlexBank Request for Reimbursement Form

FlexBank Employee Direct Deposit Authorization Form

FlexBank Dependent Care Request for Reimbursement Form

FlexBank Change of Status Form

2012 Health Insurance Enrollment Forms -

2012 Credit Union Comparison

2012 Wright Patterson Credit Union HSA Sign Up Form

2012 Day Air Credit Union HSA Sign Up Form

2012 CODE Credit Union HSA Sign Up Form

2012 Flexible Spending Account – Eligible Expenses

2012 Flexible Spending Account – Estimate Worksheet

2012 Health Savings Account /FSA Annual Enrollment Form

2012 Health Reimbursement Account Annual Enrollment Form

2012 Employee Direct Deposit Authorization Form

2012 United Health Care Change/ Cancelation Form

2012 City of Kettering Waiver of Insurance Form

2012 Flex Spending Acct / Health Reimbursement Acct Claim Form

2012 Dental Insurance Summary

2012 Dental Enrollment or Change Application

2012 HSA Prefund Form