Forms

General Forms

Please Return Completed Forms to Human Resources

•  (PDF)Direct Deposit (PDF)
• W-4 Form (PDF)
• Change of Address (PDF)
• Decedent's Warrant (PDF)
• Donated Leave Form (PDF)
• Western Montana Grower's Co-op Summer 2019 (PDF)
• FMLA - Employee Packet (PDF)
• Pregnancy Related Medical Leave Form (PDF)
• Performance Appraisal Forms (PDF)
• Authorization to Release Information (PDF)
• City of Missoula Application  (PDF)
• City of Missoula Police Department Application

Benefits Forms

Return Completed Forms to Human Resources

• Blood Screening Verification (PDF)
• Dependent Child Certification (PDF)
• Direct Deposit of Flex Reimbursement (PDF)
• Declaration of Domestic Partnership (PDF)
• Supplemental Vision Enrollment Form (DOC)
• Flexible Benefits Enrollment Form (PDF)
• Flex News Brochure (PDF)
• Joint Processing Form (PDF)
• Request for Health Plan Enrollment Change (PDF)

Return the Following Forms to Allegiance

• Medical Claim Form (PDF)
• Medical Flex Claim Form (PDF)
• Dependent Care Flex Claim Form
• Daycare Reimbursement Contract

Pharmacy Benefit Forms

• Ridgeway Drug Mail Order Form (PDF)
• Costco Mail Order Form

Deferred Compensation

Return the Deferred Compensation Plans forms to the Human Resources Office.