Forms
Employment Forms
Please email completed forms to Human Resources, hrnewhire@ci.missoula.mt.us
To digitally sign forms, download, and/or open with Adobe PDF Reader.
- Decedent’s Warrant (PDF)
- Direct Deposit (PDF)
- Employee Records (PDF)
- Federal W-4 (PDF)
- FURS Membership [Fire Only] (PDF)
- Hiring Authorization/Vacancy Notice (PDF)
- I-9 Acceptable Documentation (PDF)
- Montana W-4 (PDF)
- MPORS Membership [Police Only] (PDF)
- PERS Membership (PDF)
- PERS Optional Membership (PDF)
- Prior Employment Certification (PDF)
- Social Security Exemption [Police & Fire Only] (PDF)
- Voluntary Self Identification (PDF)
Leave Forms
- Leave Donations (PDF)
- Request for Donated Leave (PDF)
- FMLA Medical Certification (PDF)
- FMLA Request Form (PDF)
- FMLA Return to Work Certification (PDF)
- Pregnancy-Related Medical Leave Form (PDF)
Benefits Forms
To digitally sign forms, download, and/or open with Adobe PDF Reader.
Return Completed Forms Electronically to HR Scans or email, departmentH@ci.missoula.mt.us.
- Benefits at a Glance (PDF)
- Blood Screening Verification (PDF)
- Flexible Benefits, Direct Deposit of Reimbursement (PDF)
- Declaration of Domestic Partnership (PDF)
- Supplemental Vision Enrollment Form (DOC)
- Flexible Benefits Enrollment Form (PDF)
- Joint Processing Form (PDF)
- Request for Health Plan Enrollment Change (PDF)
- UNUM - Portability Form (PDF) [Return to UNUM]
- UNUM - Supplemental Life Insurance Enrollment Form (PDF)
Return the Following Forms to Allegiance
- Medical Claim Form (PDF)
- Medical Flex Claim Form (PDF)
- Dependent Care FSA Reimbursement Request Form (PDF)
- Daycare Reimbursement Contract (PDF)
Pharmacy Benefit Forms
- Ridgeway Drug Mail Order Form (PDF)
- Costco Mail Order Service: Please contact the HR Office for instructions.
Deferred Compensation
Return the Deferred Compensation Plans forms to the Human Resources Office.