Forms for Employees
Documents are in PDF unless specified otherwise.
- Direct Deposit Form
- Expense Reimbursement - 2018 Calendar Year
- Expense Reimbursement - 2019 Calendar Year
- HSA (Health Savings Account) Payroll Deduction Authorization
- Incident Report Form
- Name and/or Address Change for Employees
- Member Forms (Enrollment, Mid-Year Change, Beneficiary Designation, etc.)
- Reference Authorization Form
- Carruth Compliance Consulting (CCC) is the third party administrator and primary point of contact for Lane ESD's 403(b) TSA plan. Go to CCC's website for current Lane ESD TSA information.
- W-4 Form - IRS
- W-4 Form - Oregon
- Worker's Compensation Claim Form 801 and Instructions
For more information contact:
Human Resources at 541-461-8202 or firstname.lastname@example.org