Payroll and benefits information and forms
Links to forms related to payroll and benefits are listed below for your convenience.
Adjunct academic employee leave report CCS 1675
Affidavit of lost/destroyed check (SBCTC)
Complete this form to have a payroll check reissued. Must be notarized. See Paycheck FAQs for information regarding the mandatory waiting period. Following is a link to a list of CCS Notary Publics.
Classified employee time sheet CCS 1647
Complete this form to report hours if the reporting period is outside the online time certification period, or if extending beyond your normal cyclic calendar.
Direct deposit application CCS 2613
Complete this form to have direct deposit to your bank.
Employee address change form CCS 2144 | Word version
Foundation employee pledge form CCS 1827
Complete this form to make a payroll deduction pledge to the CCS Foundation. If you need assistance choosing a fund, please contact the foundation office at 434-5123.
Notification of ability to average CCS 2153
Notification of payroll overpayment, nonrepresented CCS 2142
Payroll deduction authorization for annual parking permit CCS 2614
CCS employee tuition waiver form CCS 40-130
For eligible employees, complete this form to have the tuition waived for up to six (6) credits taken at CCS or another eligible institution. Must be signed by your supervisor and sent to HR.
Verification of student status at public college or university other than CCS CCS 2150
Weekly time & effort report CCS 2139
Workstudy notification of ineligibility for membership in the Washington State Retirement System CCS 2149
W-4 employee's withholding allowance certification IRS-W4
Complete this form if you wish to change your payroll deductions for federal taxes.
2015 Employee Enrollment / Change form
Life Insurance Enrollment / Change form
Life Insurance Evidence of Insurability form
Change of Beneficiary
Long Term Disability Enrollment / Change form
Long Term Disability Evidence of Insurability form
All participant forms can be downloaded as fillable PDFs from the VEBA website.
VEBA Enrollment form
Claim Form for expenses
Account Change form
Direct Deposit Enrollment form
Systematic Premium Reimbursement form
Election of Limited VEBA Plan Coverage form
FLEXIBLE SPENDING / DEPENDENT CARE
All FSA & DCAP forms
HEALTH SAVINGS ACCOUNT (HSA)
The Health Savings Account is only available if you are enrolled in a Group Health CDHP or Uniform CDHP.
Basic TIAA/CREF retirement plan salary reduction agreement
Voluntary salary reduction agreement
DRS member information form
DRS beneficiary designation form
DRS name/address change form
DRS retirement status form
DCP participation agreement form