Forms (Staff Resources)
Calendars
Employee Fact Sheets
For your convenience, the following forms may be downloaded and forwarded to HR for processing:
- Absence Request Form- Rev. 10/23
- Field Trip Request Form
- Fundraiser Request Form
- Professional Development Request Form
- Disposal Request Form
- Student Activities Sheet
- Homebound Instruction Form
- Personal Information Change Form
- 2024 W-4 Form (Federal)
- NJ W-4- Form
- W-9
- 403b Salary Reduction Agreement Form Rev. 1-24
- Direct Deposit Authorization (A blank “Voided” check must accompany this form. Both documents should be submitted to the Payroll Department for processing)
- 2024-2025 Summer Pay Form (Must also submit a W-9 and copy of driver's license- send to the Payroll Department for processing)
- Payroll Voucher
- Payroll Voucher Due Dates 2023-2024
- Payroll Voucher Due Dates 2024- 2025 (NEW)
- Tax Shelters-Disability Insurance Carriers
- Course Reimbursement-Procedures
- Course Reimbursement Application (Support Staff)
- Course Reimbursement Application (Certificated Staff)
- TPAF Handbook
- PERS Handbook
- NJ First Act
- Flexible Spending Plan 2023-2024
- Flexible Spending Plan 2024-2025 (NEW)
- Qualified Transportation and Parking Fringe Benefit 2023-2024
- Qualified Transportation and Parking Fringe Benefit 2024- 2025 (NEW)
Family Medical Leave Act
The following Fact Sheets provide information on your rights as they pertain to the Family Medical and Leave Act. Additional information may be obtained by visiting the NJ Department of labor at http://www.wagehour.dol.gov. To obtain a Certification of Healthcare Provider application, you must contact Human Resources to verify eligibility requirements.
- FMLA Employee Guidebook
- Family and Medical Leave Act- Fact Sheet #28
- Employee Protections under the Family and Medical Leave Act- Fact Sheet #28A
- FMLA for birth, bonding or to care for a child with a serious health condition- Fact Sheet 28B
- FMLA to care for a parent with a serious health condition- Fact Sheet #28C
- Employee Notice Requirements for FMLA- Fact Sheet 28E
- Military Leave Provisions under FMLA- Fact Sheet #28M
The following Fact Sheets and Forms are provided courtesy of the NJ Division of Pensions and Benefits to ensure you and your family are adequately covered:
Health Benefits
- Percentage of Premium Calculation Charts (NJ Direct 10 and NJ Direct 15)
- NJ Educators Health Plan Member Contribution Rates (NJEHP and GSHP)- Plan Year 2024 (NEW)
- Percentage of Premium Contribution Calculator (NJ Direct)- Plan Year 2024 (NEW)
- NJ School Employees' Health Benefits Program (SEHPB) Overview- Plan Year 2024 (New)
- NJ School Employees' Health Benefits Program Monthly Rates- Plan Year 2024 (NEW)
- NJ School Employees' RX Copay Rates- Plan Year 2024 (New)
- Garden State Health Plan Overview- Plan Year 2024 (NEW)
- AETNA (SEHBP) Plan Overview- Plan Year 2024- (NEW) effective 7/1/24
- Optum RX- FAQ- Plan Year 2022
- NJ Direct and NJ Educators Health Plan Guidebook- 2023 (NEW)
- Prescription Drug Plan Member Guidebook (4/23)
- Chapter-78, PL-2011
- Reporting a Death- Fact Sheet #10
- Leave of Absence and Your Health Benefits- Fact Sheet #20
- The Continuation of Health Benefits Under COBRA- Fact Sheet #30
- COBRA Monthly Rates- Plan Year 2024 (NEW)
- Health Benefits at Termination- Fact Sheet #31
- Family Status Changes- Fact Sheet #48
- Continuing Health Benefits for Overage Children with Disabilities- Fact Sheet #51
- Identity Theft and Your Benefits- Fact Sheet #72
- Health Benefit Coverage Under Chapter 375- Fact Sheet #74
- Chapter 375 Monthly Rates- Plan Year 2024 (NEW)
- Civil Unions- Fact Sheet #75
- Dependent Documentation- Fact Sheet #88
- Designating a Beneficiary - Fact Sheet 68
- Notification of Health Benefits Rights- 2024
- Medicare Part A & B
Purchase of Service & Pension Loans
- MBOS Registration Directions
- Purchasing Service Credit- Fact Sheet #1
- Pension Loans- Fact Sheet #81
Retirement
- Retirement Planning Handbook
- Applying for Retirement- Fact Sheet #4
- Pension Options- Fact Sheet #5
- Retirement Checklist- Fact Sheet #6
- Enrolling in Health Benefits Upon Retirement- Fact Sheet #11
- Taxation of Retirement Benefits- Fact Sheet #12
- Conversion of Group Life Insurance- Fact Sheet #13
- Deferred Retirement- Fact Sheet #14
- Disability Retirement- Fact Sheet #15
- Retiree Health Benefit Program and Medicare A& B- Fact Sheet #23
- Withdrawal from the Retirement System- Fact Sheet #24
- Family Status Changes- Retirees- Fact Sheet #49
- About Your Retirement Check- Fact Sheet #64
- Designating a Beneficiary- Fact Sheet #68
- Retiree Dental Plans- Fact Sheet #73
- Employment after Retirement- Fact Sheet #86
Additional information may be downloaded and/or printed directly by visiting: www.state.nj.us/treasury/pensions