Trenton Public Schools

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Payroll/Human Resources' Forms

If you have any questions about any of the forms on this page please contact Human Resources at 734-692-4514.

**If you choose to submit any PDF forms via email (by using the email button at the top of the form) please make sure you forward any additional, required documents to the appropriate department in the central office within one week.

         MEDICAL
BCBS Website

BCBS Change Form
Rx Change Form

BCBS Change Form

Rx ChangeForm




DENTAL
ADN Website

Dental Summary - Plan Description

Summary Plan Description

TESP Dental Benefits At A Glance

Admin/Office Dental Benefits At A Glance

Benefits At A Glance
TESP Union

Benefits At A Glance
Administration/Office
 

Teachers Dental Benefits At A Glance

Dental Change Form (ADN)

Benefits At A Glance
Teachers

Dental Change Form



VISION
Davis Vision Website

TESP Vision Benefits At A Glance

Vision Benefits At A Glance - Non TESP

Benefits At A Glance
TESP Union

Benefits At A Glance
Teachers & Administration

Vision Change Form (Davis)
Out Of Network Claim Form

Vision Change Form (Davis)

Out of Network Claim Form





PAYROLL

08/09 Pay Calendar
09/10 Pay Calendar

08/09 Pay Calendar

09/10 Pay Calendar

Direct Deposit Form
Salary Payment Option

Direct Deposit Form

Salary Payment Option


W4


MI-W4

W4

MI-W4 


Salary Credit Beyond B.A.


Salary Credit Beyond M.A.

Salary Credit Beyond B.A

Salary Credit Beyond M.A








FLEXIBLE SPENDING ACCOUNTS
Basic Flex Website

Reimbursement Claim Form
 FSA Enrollment Booklet & Application

Reimbursement Claim Form

FSA Enrollment Booklet
& Application






LIFE INSURANCE

Beneficiary Designation Form

Beneficiary Designation Form





FMLA

Request Form

Request Form






NEW EMPLOYEES/APPLICANTS

Fingerprint Request Form

Fingerprint Request Form





403B

403B Enrollment - Teachers Only

403B Enrollment Form
*Teacher's Only*


  STATE OF MICHIGAN & ORS
BCBS Website

ORS Public School Employee Website
ORS Login

ORS Public School Employees Website

Retirement System Login




MISCELLANEOUS FORMS

Mileage Reimbursement Form

Mileage Reimbursement Form