Employee Forms

Tax Forms

Missouri State W-4 Tax Withholding Form

Federal W-4 Tax Withholding Form

Group Benefit Services (GBS) Insurance Forms

2017 Flexible Spending Account (Flexible Benefit) Plan Change Form

2018 Flexible Spending Account (Flexible Benefit) Plan Change Form

2017 Flexible Spending Account (Flexible Benefit) Claim Form

2018 Flexible Spending Account (Flexible Benefit) Claim Form

2018 Flexible Spending Plan  (Flexible Benefit) Worksheet w/Eligible Reimbursable Items List 

Direct Deposit Authorization Form For Employee Paid Insurance Claim Reimbursements

Event Change (Medical, Dental, Vision, Life)Form

Reimbursable Deductible Allowance FAQ (Frequently Asked Questions) Guide

AFLAC Forms

Accidental Claim Form

Cancer Wellness Benefit Claim Form

Vision Claim Form

Wellness Benefit Claim Form

Adair County Employee Forms

Incident Report Form-General 

Incident Report Form-Road & Bridge

Injury Form-Workplace

Medical Authorization Form

Payroll Direct Deposit Form

 Payroll Direct Deposit Stop Form

Sick Leave Donation Form

YMCA Membership (Corporate) Application

YMCA Payroll Deduction

 

 

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