HRP Employment Forms

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)

State and Federal W-4 Tax Exemption Forms
Federal IRS Form W-4 Employee's Withholding Allowance Certificate (with Deductions and Adjustments Worksheet)
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)

Health Insurance (HMSA Preferred Provider & HPH HMO)
Health Benefit Coverage Monthly Rates (2005-2006)
Medical/Dental Coverage and Copayment Information (HMSA Preferred Provider and HPH Plus) 2005-06
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
Jefferson Pilot Insurance Company Group Life Enrollment Form
Jefferson Pilot Life Insurance Certificate

Checking/Savings Account/Authorization for Direct Deposit Form
Direct Deposit Form

Insurance Program Conversion Applications and Instructions
Life Insurance Conversion Form
Life Insurance Conversion Form Instructions & FAQ
Long-Term-Disability Conversion Form
Long-Term-Disability Conversion Form Instruction