Payroll – Benefit Forms
IMPORTANT
*All ORIGINAL SIGNED FORMS must be returned to Marisa Forchione, Payroll/Benefits Dept., with the Open Enrollment Form. Descriptions of your plans are found in your union contract booklets.
Upon completion of the following forms, please submit them:
via interoffice mail to the Payroll Department in Central Office or
via postal mail to Weston Public Schools, Payroll Department, 24 School Rd, Weston, CT 06883.
- Change of Name and/or Address Google Doc link for HR use only. For Payroll, please fill out the original form and send to Marisa Forchione.
- Taxes: Federal W-4
- Taxes: Connecticut W-4
- Connecticut Income Tax Withholding Requirements for Connecticut Employees
- Employment Verification Form: I-9
State Partnership Plan 2.0 Information
United Healthcare Enrollment Form
Annual Open Enrollment Forms:
- Non-Certified Staff – AFSCME 10 & 11 Month – AFSCME 12 Month
- Non-Represented – Central Office
- Administrators – WAA
- Certified Staff – WTA
How to Close your HSA and Account Closure Form
- Delta Dental Information
- Delta Dental Web-Site – click here
- Delta Dental Enrollment Form
- Dental Claim Form
- Prudential Optional Life Insurance Information
- Prudential General Information/Rates
- Prudential Enrollment Form
- Prudential Beneficiary Form
- Short Form EOI Document
- Form for Group Life Insurance Beneficiary Changes
- Direct Deposit
- MERS (Municipal Employees Retirement System) –Non-Certified Pension
- Teacher’s Retirement Beneficiary Form
- Life Insurance – Change of Beneficiary Form
- Credit Union
- Section 125 Flex Spending
- Health Care Reimbursement (HCR) Account and Dependent Care Reimbursement (DCR) Account (Flexible Spending Account – FSA):
The OMNI Group
- OMNI’s Web-site click: 403B
IMPORTANT
*All ORIGINAL SIGNED FORMS must be returned to Marisa Forchione, Payroll/Benefits Dept., with the Open Enrollment Form.
Descriptions of your plans are found in your union contract booklets.