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Forms A-Z

A


Alternate Work Schedule Agreement   

B


Beneficiary Designation (CalPERS)  
Beneficiary Designation (Cigna Group Insurance)   
Benefit - Proof of Other Coverage
Bilingual Pay Request - TEA
Bilingual Pay Request - POA
 
  


C


Catastrophic Time Donation Form 
Cell Phone Stipend Certification  
Certification of Health Care Provider (FMLA)   

E


Employee Benefit Change Form - Dental  
Employee Benefit Change Form - Medical  
Employee Benefit Change Form - Vision  
Employee Information Change Form
Employee Emergency Contact Information  
Employee Request for Family or Medical Leave (FMLA)  

F

 
Flexible Spending Account Reimbursement Voucher 

I


ICMA - Loan Program Brochure  
ICMA - RC 457 Enrollment Kit
ICMA - RC 457 Deferred Compensation Plan Employee Enrollment Form 
ICMA - RC 457 Deferred Compensation Plan Amount of Deferral Change Form  
ICMA - RC 457 Deferred Compensation Pre-Retirement Catch-Up Form 
ID Badge Request Form  

L


Los Gatos Town Employee Foundation (LGTEF) Enrollment Form    
 
O
Outside Employment Application
   
P
Power of Attorney (CalPERS)
 
   

T


Tuition Reimbursement Request Form   



W


Worker's Comp Claim Form (DWC 1)
Worker's Comp Injury/Incident Investigation Report
  
Workers Comp Medical Facilities
 
  

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