Employment Forms

Many of these forms are in the Adobe Portable Document Format (PDF). You must have Adobe Acrobat installed on your system to view these files.
As a reminder, it is not necessary to complete these forms at present. They are available primarily as an advance organizer to help you gather necessary documents and information you will need to complete the forms at the Residents' Orientation.
Identity and Employability Documents
U.S. Department of Justice Form I-9 Employment Eligibility Verification (Includes List of Acceptable Documents) PDF 418k KB Form Fillable
Link to Social Security Online
 Use this website to get a Social Security number and Social Security card
EEO Voluntary Self Identification Form
 PDF 12 KB
State and Federal W-4 Tax Exemption Forms
Federal IRS Form W-4 Employee's Withholding Allowance Certificate (with Deductions and Adjustments Worksheet) PDF 225 KB Form Fillable
State of Hawaii Form HW-4 Employee's Withholding Allowance and Status Certificate (with Worksheet to Figure Your Withholding Allowances and Deductions and Adjustments Worksheet) PDF 227 KB Form Fillable
Health Insurance (HMSA Preferred Provider & HPH HMO)
Health Benefit Coverage Monthly Rates (2007-2008)
Medical/Dental Coverage and Copayment Information (HMSA Preferred Provider Plan and HPH Plus) 2008-09
Preferred Provider Plan Information
Health Plan Hawaii Medical Benefits Summary
Health Plan Hawaii Member Handbook
HMSA Medical/Dental Plan Enrollment
HMSA Student Certification Form
Life Insurance
Group Life Enrollment Form
Life Insurance Conversion Form
Life Insurance Conversion Form Instructions & FAQ
Checking/Savings Account/Authorization for Direct Deposit Form
Direct Deposit Form
Long Term Disability Insurance Conversion
Long-Term-Disability Conversion Form
Long Term Disability Income Protection Plan
Resident Long Term Disability Income Protection Plan Highlight Sheet
Non-Resident Long Term Disability Income Protection Plan Highlight Sheet