Forms

HR Related Forms

Application - Employment (fillable pdf)

 

Required for every new hire
Application - Volunteer (jpg, pdf)Revision "coming soon" Required for each volunteer

Address Change Form

 

Address Change Form (s)

  • Allegiant Care (Teamster)
  • HealthTrust (AFSCME and Non-Union Employees)
  • NHRS (Full -time Employees enrolled in NHRS)
  • Town of Milford 

Background Checks

 

  • Bureau of Elderly and Adult Services (jpg, pdf)
  • CRC - EMS CHRI Request Form 5.1.17 (pdf)
  • NH Criminal Record Check (jpg, pdf)
  • NH Division of Motor Vehicle Check (pdf)
  • Reduced Fee Request Form (pdf) (SECTION 5703.07 Fee Exemption of the Rules and Regulations for the Operation of the Central Repository: (d) Volunteers for public or private not-for-profit agencies that provide services to the elderly, the disabled or children shall be charged $10.00 for each criminal record check requested.)
  • DMV - (pdf)
 

EAP (Employee Assistance Program) and LAP (Life Assistance Program) 

 

Cigna LAP - Is available to all staff participating in the Life, STD and LTD programs.  Call 1-800-538-3543 or reach us online at https://www.advantageengagement.com/p_index.php?id_division=d00&id_module=m000.

 

HealthTrust EAP - Is available to employees, retirees, volunteers (and their household members).  Call our toll-free number 1-800.759.8122 or access Work/Life Online at AllOneHealthEAP.com username: healthtrust, password:  member

 
Emergency Contact Form (jpg, pdf)To be completed by every new hire
Enrollment Form (jpg, pdf)HR to complete

Evaluation Forms

  • Self Evaluation (pdf)
  • Annual Evaluation (jpg, pdf)
  • Mid Year Check in (jpg, pdf)
 
Exit Interview Form (pdf) 

Flexible Spending Account - HealthTrust

 

  • FSA Enrollment Form (pdf)
  • FSA Enrollee Brochure (pdf)
  • FSA Election Worksheet (pdf)
  • FSA Healthcare List of Eligible Expenses 4.2020 (pdf)
 

Hiring Checklists

 

  • New Hire Checklist (HR) (pdf)
  • New Hire Checklist (Department Heads) (jpg, pdf)
  • New Hire Checklist (Recreation) (jpg, pdf)
  • New Hire Checklist (Youth) (jpg, pdf)
 

I-9 Employment Verification Eligibility

 

I-9 Printable (Printable pdf)

I-9 Fillable (Fillable pdf)

I-9 Instructions (Exp 10.31.22)

To be completed within 3 days of hire
Job Description Template (doc)For Managers and Department Heads to use as a point of reference.
Job Requisition Form (pdf)Must be completed before posting positions on website or ApplicantPro

NH Retirement Forms - (see Benefit Information tab)

To be completed by all FT employees

Receipts (Acknowledgements)

  • Receipt of AFSCME Agreement (jpg) ) Police Officer/Detective/Master positions only
  • Receipt of Employee at Will Statement (jpg)
  • Receipt of Employee Handbook (jpg)
  • Receipt of Harassment Policy (jpg)
  • Receipt of Inclement Weather Policy (jpg)
  • Receipt of JLMC Manual (jpg)
  • Receipt of Teamster Agreement (jpg) Teamster positions only
  • Receipt of Timeclock Policy (jpg)
  • Receipt of Annual Notices 
To be completed by all new hires
Payroll Status Change Form (jpg, pdf)For new hire, rate change, address change, coming off probation, termination, etc.
Request for Leave of Absence (jpg not fillable, pdf fillable)For anyone going out on leave
Request to Waive Lunch (jpg, pdf)Voluntary waiver to work through lunch.  
Reference Check Form (pdf) 
Second Injury Form (pdf)To be completed with Human Resources

Tuition Reimbursement 

EDUCATION REIMBURSEMENT POLICY (and forms)

Eligibility:Eligible employees include full-time, non-union employees who have successfully completed their probationary period.

Worker's Compensation

 

__________________________________________

 

Town of Milford Specific

To be completed in the event of a workplace accident. 

 

ALL forms should be returned to HR ASAP.

 

Payroll Related Forms

Direct Deposit - Start (jpg, pdf)

Notice to all employees 9/2019 - Direct Deposit Process 

Has to be completed to process direct deposit request (please attach a copy of a canceled check) 

 

Direct Deposit - Terminate (jpg, pdf)Has to be completed if you need to change direct deposit accounts.  Current account needs to be terminated, then a new direct deposit form completed.
M-4 Massachusetts Employee's Withholding Exemption Certificate (jpg, pdf)Has to be completed by employee if employee resides in MA (MA Employee also has to complete a w-4)
Payroll Status Change Form (jpg, pdf)Payroll Status Change Form - Fillable
2021 w-4 (pdf)

Has to be completed upon hire and when any changes need to be made to withholding

 

About Form W-4

 

IRS Withholding Calculator

2020 Expense Reimbursement Form (pdf, excel)Travel and Personal Expense Reimbursement

Other Forms

Hampshire Hills

Hampshire Hills Flyer 75 off

 

Rate Information Sheet

Quarterly Billing Change 4.1.2020 Memo

Employee Billing Change 4.1.2020 Memo

 

Volunteer Affadavit revised 6.2020 (pdf)

 

Any volunteer or employee can sign up for the membership under the Town's umbrella.  The membership must be in the volunteer's name.  The volunteer must be 18 or over to receive this benefit - involves signing agreements.

 

See "How do I" tab for addtional information on signing up for Hampshire Hills