Human Resources Forms & Information
COVID-19 City of Burlington Employee Forms and Information
- COVID-19 Exposure Plan
- COVID-19 Self Reporting Form
- Emergency Leave Policy
- Emergency Leave Request Form COVID-19
- Families First Coronavirus Response Act (FFCRA) Expanded Family & Medical Leave FAQ
- FFCRA Employee Rights Poster
- Protocols for COB COVID-19 Positive Cases
- Cloth Face Covering Policy
Basic Employment Forms
- I-9 Form
- 2020 W-4
- Declaration of Health Care
- Employee Change of Status form
- Employee Personal Information Questionnaire
- Designation of Beneficiary Form
Comprehensive Personnel Policy Manual/ Federal & State Labor Law Posters
Contracts
Dental Insurance Forms
Domestic Partner Enrollment Forms
ICMA-MissionSquare Retirement & Nationwide Forms
- How Your 457 Plan Works - 4 Minutes Video
- Employee Information Change Form ICMA
- 457 Amount of Deferral Change Form ICMA
- Nationwide 457 plan form
- Nationwide 457 Fillable Form
- Nationwide 457 QR Code
- IRS 2022 Retirement Plan Contribution and Benefit Limits
Flexible Spending & DCAP Forms
Parental, Medical, or Family Request Form
Health Insurance / Prescription
- Cigna Medical Health Insurance Form
- Cigna Medical Health Health Plan Summary
- COBRA Continuation Notice
- Notice of HIPAA Privacy Practices
- Affordable Care Act Marketplace Notice
- Health Insurance Buyout Form
- CanaRx BurlingtonMeds
Miscellaneous HR Materials
- Holiday List 2022
- Livable Wage Ordinance
- Reasonable Suspicion Checklist
- Reasonable Suspicion Training Frequently Asked Questions
- Sustainability Presentation
- Director of Aviation Job Information
