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, unless otherwise directed.
- Blood Screening Verification
- COBRA, Qualifying Event Form
- Declaration of Domestic Partnership
- Flex, Daycare Reimbursement Contract
- Flex, Debit Card Enrollment Form
- Flex, Direct Deposit
- Flex, Enrollment/Change Form
- Flex, Joint Processing Form
- Flex, Limited Purpose Reimbursement Request
- Flex, Parking/Transportation Enrollment/Change Form
- Health, Enrollment/Change Request
- Nationwide, Enrollment/Change Request
- Nationwide, Payroll Authorization Form
- PERS Authorization for Deductions of Health Insurance Premiums
- Pharmacy, Costco Mail Order Form
- Pharmacy, Ridgeway Drug Mail Order Form
- UNUM, Accident Enrollment Form
- UNUM, Coverage Change Request
- UNUM, Evidence of Insurability
- UNUM, Portability Form
- UNUM, Term Life Enrollment Form
- VALIC, Enrollment/Change Request
- Vision, MetLife Enrollment/Change Request
Claims
- Address/Name Change
- Aquatic Annual Pass Agreement
- Aquatic Payroll Deduction Form
- Comp Time Accrual Request
- Direct Deposit
- FURS Membership [Firefighters Only]
- MPERA Name Change Form (FURS, MPORS & PERS)
- MPORS Membership [Police Officers Only]
- Parking, Lease Parking Deduction Form
- Parking, Luke Pin Agreement
- Payroll Copy Request
- Payroll Edit Slip Template (XSL)
- Payroll, Electronic Forms Authorization
- Payroll Exempt Time Sheet (XSL)
- PERS Membership
- Verizon Employee Discount
- W-4, Federal
- W-4, Montana
- COVID Additional 30-day Leave Request
- COVID Donation Request Form
- COVID Extended FML Request
- COVID Leave Donation Form
- COVID Sick Leave Request
- Donation, Leave Donations
- Donation, Request for Donated Leave
- Excess Annual Leave Plan
- FMLA Medical Certification
- FMLA Request Form
- FMLA Return to Work Certification
- Leave Adjustment Form
- Pregnancy-Related Medical Leave Form
Please email completed forms to hrnewhire@ci.missoula.mt.us
- Decedent’s Warrant
- Direct Deposit
- Employee Records
- W4, Federal
- FURS Membership [Firefighters Only]
- I-9 Acceptable Documentation
- I-9, Employment Verification
- W4, Montana
- MPORS Membership [Police Officers Only]
- PERS Membership
- PERS Optional Membership
- Prior Employment Certification
- Social Security Exemption, SSA-1945 [Firefighters & Police Officers Only]
- Voluntary Self Identification
- Address/Name Change Request
- Aquatic Annual Pass Agreement
- Aquatic Payroll Deduction Form
- Blood Screening Verification
- Classification, Request for Review
- COBRA, Qualifying Event Form
- Comp Time Accrual Request
- COVID Additional 30-day Leave Request
- COVID Donation Request Form
- COVID Extended FML Request
- COVID Leave Donation Form
- COVID Sick Leave Request
- Decedent's Warrant
- Declaration of Domestic Partnership
- Direct Deposit
- Donation, Leave Donations
- Donation, Request for Donated Leave
- Employee Records Form
- Employee Status Form (XSL)
- Excess Annual Leave Plan
- Flex, Daycare Reimbursement Contract
- Flex, Daycare Reimbursement Request
- Flex, Debit Card Enrollment Form
- Flex, Direct Deposit
- Flex, Enrollment/Change Form
- Flex, Health FSA Reimbursement Request
- Flex, Joint Processing Form
- Flex, Limited Purpose Reimbursement Request
- Flex, Parking Reimbursement Request
- Flex, Parking/Transportation Enrollment/Change Form
- Flex, Transportation Reimbursement Request
- FMLA Medical Certification
- FMLA Request Form
- FMLA Return to Work Certification
- FURS Membership [Firefighters Only]
- Health, Enrollment/Change Request
- Health, Medical Claims
- Hiring Authorization/Vacancy Notice Form
- Hiring Status Form
- I-9, Employment Verification
- Leave Adjustment Form
- MPERA Name Change Form [FURS, MPORS & PERS]
- MPORS Membership [Police Officers Only]
- Nationwide, Enrollment/Change Request
- Nationwide, Payroll Authorization Form
- Parking, Lease Parking Deduction Form
- Parking, Luke Pin Agreement
- Payroll Copy Request
- Payroll Edit Slip Template (XSL)
- Payroll Exempt Time Sheet (XSL)
- Payroll, Electronic Forms Authorization
- PERS Authorization for Deductions of Health Insurance Premiums
- PERS Membership
- PERS Optional Membership
- Pharmacy, Costco Mail Order Form
- Pharmacy, Ridgeway Drug Mail Order Form
- Pregnancy-Related Medical Leave
- Prior Employment Certification
- Social Security Exempt, SSA-1945 [Firefighters & Police Officers Only]
- UNUM, Accident Claim Form
- UNUM, Accident Enrollment Form
- UNUM, Coverage Change Request
- UNUM, Evidence of Insurability
- UNUM, Portability Form
- UNUM, Term Life Enrollment Form
- VALIC, Enrollment/Change Request
- Verizon Employee Discount
- Vision, MetLife Enrollment/Change Request
- Voluntary Self Identification
- W4, Federal
- W4, Montana
- Worker's Comp, First Report of Injury
- Worker's Comp, Incident Report
- Worker's Comp, Medical Status Form
- Worker's Comp, Prescription Payment Authorization