| Form Title |
When/How to Use |
2010 Earned Income Credit
W-5 |
This form must be filled out on a yearly basis if you are claiming the Earned Income Credit throughout the year. This form can be filled out on-line. |
| 2010 Federal Withholding W-4 |
This form must be used to change your Federal withholdings. This form can be filled out on-line. |
| AZ State Withholding A-4 |
This form must be used to change your State Withholdings. This form is effective for wages paid after June 30, 2010
This form can be filled out on-line. |
| Application for Educational Assistance |
This form must be used by regular status employees requesting Educational Assistance in accordance with County Admin Procedure 11-1(II 12). |
| ASRS Change of Beneficiary |
This form must be used to change your beneficiary for the Arizona State Retirement System. |
| *ASRS Change of Name or Address |
This form must be used to change your name or address for the Arizona State Retirement System. |
| *Basic
Life Insurance Change |
This
form must be used to change your name or address on
the Basic Life Insurance. |
| CORP Change of Name or Address |
This form must be used to change your name or address through AOC-Corrections Officer Retirement System. |
| CORP Change of Beneficiary |
This form must be used to change your beneficiary through AOC-Corrections Officer Retirement System. |
| Delta Dental Claim Form |
Delta Dental Claim Form. |
| Direct Deposit Form |
This form may be used by an employee to request, change or cancel a direct deposit. |
| Elected Officials Name or Address Change: |
Elected Officials Retirement System Name or Address Change. |
| Elected Officials Change of Beneficiary |
Elected Officials Retirement System Change of Beneficiary. |
| Flexible
Spending Account Healthcare Reimbursement |
This
form must be used to submit a reimbursement claim on
your flexible spending account - healthcare. |
| General Grievance Form |
This form may be used by a regular status employee to file a general grievance. |
| Holiday Calendar for
2010 |
This form will provide you with all of the paid holiday dates for 2010. |
| ICMA Change of Name, Marital Status, Beneficiary Changes |
ICMA Deferred Compensation Change of Name, Marital Status, Beneficiary Changes. |
| *Lincoln Financial Group Insurance Company Voluntary Group Insurance Change Request Form |
This form should be submitted if you are a benefits eligible employee, enrolled in voluntary life insurance, and wish to change your name, address or beneficiary. |
| Mail
Order Prescription Form |
This
form may be used to order your prescriptions through
the mail. |
| Medical Claim Form |
Medical Claim Form. |
| Nationwide Deferred Comp Beneficiary Change Form: |
Nationwide Beneficiary Change Form. |
| Nationwide Deferred Comp Name, Address, Deferral Change Form |
This form is to be used when changing your name, address or amount of deferred compensation. |
| Outside Employment Request |
This form is to be used by employees seeking permission to perform outside employment in accordance with Judicial Merit Rule 503. |
| Payroll Calendar for
2010 |
This form will provide you with beginning and ending date for payroll periods and payroll distribution dates for 2010. |
| *Personal Information Change & Emergency Contact Information Update Form |
This form must be submitted whenever you have a name, address or phone number change. Please note: If you are submitting for a name change, you must provide proper documentation, i.e. marriage license, divorce decree, etc. |
| Request to Use PTO |
This form should be completed and submitted to your supervisor and/or your division head at least two weeks in advance of using PTO. |
| Request to Use EIB |
This form should be used by employees requesting to use EIB leave in accordance with County Admin Procedure 11-1(II 3). Employees should submit the form to their Division Head for approval and attachment to the timesheet. |
| Superior Court Judicial Certification |
This form is used monthly to certify that no cases are submitted for determination that are over 60 days old. |
| Superior Court Commissioner Certification |
This form is used monthly to certify that no cases are submitted for determination that are over 60 days old. |
| Unlawful Harassment Grievance Form |
This form and instructions may be used to file a grievance pertaining to unlawful harassment. |
| Volunteer Registration Form |
To be completed when volunteering with the courts and acceptance of the State of AZ Accident Policy. |
