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pdf File Assurant Dental Information Packet
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21.43 Kb 11/10/10 Dental Insurance
pdf File B-1 Leave Request Form
Employees should complete this form when requesting a leave of absence for more than nine consecutive days. Employee's and Principal's signature is required. Form should be submitted to the Benefits Coordinator preferrable 60 days in advance for all foreseeable leaves.
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217.92 Kb 01/25/12 Leave of Absence Forms
pdf File B-2 Doctors Certification Form
The attending physician must complete this form for all employee medical leaves including disabilities and leaves to care for immediate family members. This form must be submitted to the Benefits Coordinator with the B-1 Leave Request Form. Timeline for submitting this form is the same as the B-1 noted above.
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57.45 Kb 01/25/12 Leave of Absence Forms
pdf File B-4 Voluntary Shared Leave Application
This form is to be completed when an employee wishes to apply for voluntary shared leave (where co-workers donate leave days to the employee). The B-1 & B-2 forms must accompany this application. The completed forms should be submitted to the Benefits Coordinator. The timeline for submitting this paperwork is the same as the B-1 form noted above.
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209.17 Kb 01/25/12 Leave of Absence Forms
pdf File B-5 Voluntary Shared Leave Donation Form
This form is to be completed only by employees who wish to donate leave days to a co-worker approved to receive Voluntary Shared Leave. Employees who donate leave must be in a position which currently earns leave days. This form should be submitted to their bookkeeper/lead secretary as soon as possible.
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239.75 Kb 01/25/12 Leave of Absence Forms
pdf File Dental - Dependent Age Information
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104.43 Kb 11/10/10 Dental Insurance
pdf File Dental Enrollment Form
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68.89 Kb 01/06/11 Dental Insurance
doc File FSA Reimbursement Form
This form is used to request reimbursement from an employee's Flexible Spending Account (Unreimbursed Medical and/or Dependent Day Care Accounts).
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55.50 Kb 03/08/07 Insurance Claim Forms
pdf File NC401k - GoalMaker Election Form
By selecting the GoalMaker option, Prudential Financial will manage your investments for you according to your age, when you plan to retire, and your risk tolerance. They do all the work for you.
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N/A bytes 05/20/08 State Retirement & NC401k Forms
pdf File NC401k Address and/or Contribution Change Form
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N/A bytes 05/08/07 Address Change Forms
pdf File Reliance Standard Life Insurance - Change Form
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170.38 Kb 03/20/07 Name Change Forms
pdf File Reliance Standard Life Insurance - Change Form
This form is used for the term life insurance coverage offered by Caldwell County Schools. By completing this form employees can add or remove dependents from their policy (some restrictions apply). Once this form is completed, please submit it to the Benefits Coordinator in Human Resource Services.
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170.38 Kb 03/20/07 Insurance Forms - Change Coverage
pdf File Reliance Standard Life Insurance - Change Form
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170.38 Kb 03/20/07 Beneficiary Change Forms
pdf File Retirement - Withdrawal of Contributions (Form 5)
This form can only be used once an employee has resigned their position with Caldwell County Schools and wishes to withdraw their retirement money. Please note once money is withdrawn, the service time and all future benefits are forfeited (insurance benefits, entitlement to future retirement checks, etc.).
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N/A bytes 03/20/07 State Retirement & NC401k Forms