Fiscal Services - Payroll & Benefits Downloads

Categories

Name ▲		Size	Date	Category
	2012 DE-4	47.93 Kb	01/30/12	Tax Information
	2012-13 Medical Benefit Election Form - Active Employees	57.40 Kb	02/01/13	MEDICAL OPEN ENROLLMENT
	2012-13 Medical Benefit Election Form - Certificated RETIREE ONLY	54.85 Kb	02/01/13	MEDICAL OPEN ENROLLMENT
	2012-13 Medical Benefit Election Form - Classified RETIREE ONLY	21.46 Kb	02/01/13	MEDICAL OPEN ENROLLMENT
	2012-13 Pomona Kaiser $20 Plan Summary.pdf	15.45 Kb	02/01/13	MEDICAL OPEN ENROLLMENT
	2012-13 Pomona Kaiser $5 Plan Summary.pdf	25.45 Kb	02/25/13	MEDICAL OPEN ENROLLMENT
	2012-13 SISC Anthem HMO Narrow Summary of Benefits.pdf	231.36 Kb	03/20/13	MEDICAL OPEN ENROLLMENT
	2012-13 SISC Anthem HMO Wider Summary of Benefits.pdf	234.51 Kb	03/20/13	MEDICAL OPEN ENROLLMENT
	2012-13 SISC Anthem PPO Summary of Benefits.pdf	244.21 Kb	03/20/13	MEDICAL OPEN ENROLLMENT
	2012-13 SISC Kaiser $20 Summary of Benefits.pdf	243.18 Kb	03/20/13	MEDICAL OPEN ENROLLMENT
	2012-13 SISC Kaiser $5 Summary of Benefits.pdf	242.79 Kb	03/20/13	MEDICAL OPEN ENROLLMENT
	2013 Form W-4	44.55 Kb	01/22/13	Tax Information
	2013 Income Tax Rates	57.50 Kb	01/15/13	Tax Information
	403(B) Authorized Vendor List - IRS	318.13 Kb	05/18/11	Tax Shelter Annunities
	403(b) Vendor List and Salary Reduction Agreement	49.23 Kb	04/15/13	Tax Shelter Annunities
	Am Fidelity - Accident Claim Form	141.83 Kb	12/09/09	American Fidelity Documents
	Am Fidelity - Address Change Form	64.17 Kb	12/09/09	American Fidelity Documents
	Am Fidelity - Dependent Care Reimbursement Ack. Form	37.18 Kb	12/09/09	American Fidelity Documents
	Am Fidelity - Disability Claim Form	207.05 Kb	01/22/13	American Fidelity Documents
	Am Fidelity - Flexible Benefits Plan Guide	149.79 Kb	12/09/09	American Fidelity Documents
	Am Fidelity - Medical Expense Reimb Voucher	68.33 Kb	12/09/09	American Fidelity Documents
	Am Fidelity - Routine Pregnancy Form	252.61 Kb	01/22/13	American Fidelity Documents
	Am Fidelity - Section 125 - Direct Deposit Form	46.59 Kb	12/09/09	American Fidelity Documents
	Anthem_-_Disabled_Dependent_Certification.pdf	34.65 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Anthem_-_How_to_look_up_your_doctors_information.pdf	59.79 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Anthem_HMO__PPO_Application.pdf	210.10 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Benefit Deduction Notice Aug 2012-Classified.pdf	29.18 Kb	08/31/12	Benefits
	Benefit Deduction Notice Sep 2012-Certificated.pdf	29.15 Kb	08/31/12	Benefits
	Benefit Handbook 2010-2011	188.79 Kb	09/22/10	Benefits Handbook
	Direct Deposit - Savings Account - Bank Verification	21.34 Kb	01/03/12	Payroll/Salary Information
	Direct Deposit Authorization Form	22.39 Kb	01/03/12	Payroll/Salary Information
	ICMA Direct Deposit Authorization Form	74.34 Kb	01/30/12	ICMA-Retiree Health Savings
	ICMA Employee Benefit Eligibility Form	162.21 Kb	01/30/12	ICMA-Retiree Health Savings
	ICMA Enrollment and Change Form	270.67 Kb	01/30/12	ICMA-Retiree Health Savings
	ICMA Medical Reimbursement Form	136.84 Kb	01/30/12	ICMA-Retiree Health Savings
	Instructions_Anthem_HMO_Application.pdf	68.07 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Instructions_Anthem_PPO_Application.pdf	54.62 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Instructions_Kaiser_Application.pdf	32.90 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Jan_2013_Payroll_Attachment_Explaining_New_Medical_Coverage.pdf	109.09 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Kaiser $20 Plan_ Current Evidence of Coverage.pdf	569.52 Kb	02/25/13	MEDICAL OPEN ENROLLMENT
	Kaiser $5 Plan - Current Evidence of Coverage.pdf	567.68 Kb	02/25/13	MEDICAL OPEN ENROLLMENT
	Kaiser Meidcal Financial Assitance/Discount Form	241.37 Kb	05/07/10	Discounts
	Kaiser_Application.pdf	346.54 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Kaiser_Disabled_Dependent_Enrollment_Application.pdf	86.38 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Kaiser_Disabled_Dependent_Paperwork_Requirements.pdf	27.47 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	Lost/Damaged Payroll Check Replacement Request	28.17 Kb	12/09/09	Payroll/Salary Information
	Payroll Check - Explanation of New Stub - August 2008	340.35 Kb	04/10/13	Payroll/Salary Information
	Payroll Dept General Information	58.19 Kb	01/30/12	Payroll Dept Information
	PUSD_HMO_Directory.pdf	1.38 MB	01/30/13	MEDICAL OPEN ENROLLMENT
	PUSD_PPO_Directory.pdf	1.15 MB	01/30/13	MEDICAL OPEN ENROLLMENT
	Retiree_Communication_Explaining_New_Medical_Coverage.pdf	116.43 Kb	01/30/13	MEDICAL OPEN ENROLLMENT
	SBC_BC_2012-2013_90-C$30wRx7-25.pdf	244.21 Kb	05/17/13	MEDICAL OPEN ENROLLMENT
	SBC_CC_2012-2013_Premier20-200wChirowRx7-25.pdf	234.51 Kb	05/17/13	MEDICAL OPEN ENROLLMENT
	SBC_CC_2012-2013_SelectPremier20-200wChirowRx7-25.pdf	231.36 Kb	05/17/13	MEDICAL OPEN ENROLLMENT
	SBC_KP_2012-2013_$20wChiro.pdf	243.18 Kb	05/17/13	MEDICAL OPEN ENROLLMENT
	SBC_KP_2012-2013_$5.pdf	242.79 Kb	05/17/13	MEDICAL OPEN ENROLLMENT
	Service / Research Request Form	15.66 Kb	01/03/12	Payroll/Salary Information
	Substitute and Extra Time Payroll memo 7-8-11	18.03 Kb	07/08/11	F.A.Q. & Memos
	Tax Withholding Notice-2013	47.72 Kb	02/01/13	Tax Information
	Warrant(s) Recipient Designation Form	33.15 Kb	02/08/12	Payroll/Salary Information