Payroll & benefits information & forms
Links to forms related to payroll and benefits are listed below for your convenience.
Adjunct academic employee leave report CCS 1675
Affidavit of lost/destroyed check (SBCTC)
Complete this form to have a payroll check reissued. Must be notarized. See Paycheck FAQs for information regarding the mandatory waiting period. Following is a link to a list of CCS Notary Publics.
Classified employee time sheet CCS 1647
Complete this form to report hours if you are extended beyond your normal cyclic calendar.
Direct deposit application CCS 2613
Complete this form to have direct deposit to your bank.
Employee address change form CCS2144
Foundation employee deduction CCS 1827
Complete this form to make a payroll deduction pledge to the CCS Foundation. If you need assistance choosing a fund, please contact the foundation office at 434-5123.
Notification of ability to average CCS 2153
Notification of payroll overpayment, nonrepresented CCS 2142
Notification of payroll overpayment, represented CCS 2145
CCS employee tuition waiver form CCS 40-130
For eligible employees, complete this form to have the tuition waived for up to six (6) credits taken at CCS or another eligible institution. Must be signed by your supervisor and sent to HR.
Verification of student status at public college or university other than CCS CCS 2150
Weekly time & effort report CCS 2139
Workstudy notification of ineligibility for membership in the Washington State Retirement System CCS 2149
W-4 employee's withholding allowance certification IRS-W4
Complete this form if you wish to change your payroll deductions for federal taxes.
MEDICAL INSURANCE
Employee enrollment / change form
Spouse or qualified domestic partner certification
Student certification / change
Retiree coverage election vorm (Form A)
Dependents with disabilities
Extended (legal) dependents
COBRA continuation of coverage
LIFE INSURANCE
Life insurance enrollment form
Life insurance change form
Life insurance evidence of insurability form
Nonsmoker certification
Life insurance conversion
Change of beneficiary
LONG-TERM DISABILITY
Long-term disability enrollment / change form
Long-term disability evidence of insurability
VEBA
VEBA enrollment form
Claim form for expenses
Fund allocation form
Direct deposit enrollment form
Summary of benefits
Systematic payment form
E-statement sign-up form
Voting results (2008)
FLEXIBLE SPENDING / DEPENDENT CARE
General FSA claim form Fillable PDF Word Doc
FSA & DCAP claim form Fillable PDF Word Doc
Direct deposit / E-mail notification form
Flex Visa debit card overview and application
RETIREMENT
Basic TIAA/CREF retirement plan salary reduction agreement
Voluntary salary reduction agreement
DRS member information form
DRS beneficiary designation form
DRS name/address change form
DRS retirement status form
DCP participation agreement form