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New Hire Enrollment Packets

New Hire Enrollment Packets may be accessed by selecting the applicable state. Please forward completed packets to your Payroll Tech upon hiring.

Select Your State to View Additional Forms

Benefits	English	Spanish
Lincoln Deferral Change Form		N/A
Lincoln Enrollment and Beneficiary Form		N/A

Claims Administration	English	Español
Accident Investigation Report
CA State Claim Form (DWC-1)
Claims Reporting Procedures Packet
Consent for Release of Medical Information
Employee Refusal of Medical Treatment

Claims Procedures	English	Español
Claims Reporting Procedures Flowchart
Workers' Compensation Claim Protocols

Loss Control And Safety	English	Español
New Hire Safety Orientation Checklist
Post Accident Safety Sign Off Sheet
Progressive Discipline Program Form
Safety Meeting Sign Off Sheet
Safety Suggestion Form
Client Work Site Safety Evaluation		N/A

Payroll Administration	English	Español
Direct Deposit Cancellation Form
Direct Deposit Reversal Affidavit Form
Lost Payroll Check Affidavit
Payroll Advance Deduction Authorization
Money Network PayCard
Employee Data Change Form
Employee Separation Form

Generic Forms	English	Español
New Hire Data Input Form
Direct Deposit

Workers’ Compensation	English	Español
Certificate Request Form
New Class Code Location Request Non-Temporary Staffing

Workers’ Compensation Poster	English	Español
Construction*
Farming
Light Industrial*
Warehousing*

* Full-color printed posters are available upon request.

Workers’ Compensation	English	Español
Alabama PEO Notice		N/A