East Ramapo Central School District

A unified community educating the whole child

Accounting/Payroll Forms

Omni 403B Contribution Limit 2023 Memo

Omni 403B Contribution Limit 2023 Memo.pdf 240.47 KB (Last Modified on January 17, 2023)

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Omni 403B SRA form

Omni 403B SRA form.pdf 342.27 KB (Last Modified on January 17, 2023)

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Overtime and Substitute Payroll Schedule 2022-2023

OT and Substitute PR Schedule 2022-23.pdf 465.37 KB (Last Modified on January 5, 2023)

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2023 NYS IT 2104

2023 - IT-2104 - NYS form.pdf 487.04 KB (Last Modified on January 5, 2023)

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2023 W-4

2023 Form W-4.pdf 88.54 KB (Last Modified on January 5, 2023)

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OT and Substitute PR Schedule 2022-23

OT and Substitute PR Schedule 2022-23.pdf 465.37 KB (Last Modified on September 9, 2022)

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Health-Dental-Aflac Deduction Schedule 2022-23

Health-Dental-Aflac Deduction Schedule 2022-23.pdf 425.55 KB (Last Modified on January 5, 2023)

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Voucher for Overtime and Extra Pay

Voucher for Overtime and Extra Pay.doc 35 KB (Last Modified on March 24, 2020)

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Salary Method of Payment for 10 Month Employees

Salary Method of Payment.pdf 189.79 KB (Last Modified on August 29, 2018)

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Direct Deposit Authorization Form

Direct Deposit.pdf 60.11 KB (Last Modified on February 25, 2020)

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Expense Reimbursement Procedures - Updated 2016

Expense-Reimbursement-Procedures-01-16.pdf 649.675 KB (Last Modified on January 16, 2018)

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Wageworks FSA Guidelines

Wageworks FSA Guidelines.pdf 1.22 MB (Last Modified on May 15, 2019)

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Wageworks Participant Flyer

WW Participnt Flyer.pdf 1.66 MB (Last Modified on May 15, 2019)

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Memo - W-2 Health Benefits

Memo-W-2-Health-Benefits.pdf 46.779 KB (Last Modified on January 16, 2018)

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Rockland Employees Federal Credit Union Payroll Deduction Form

Rockland-Emp-Fed-CreditUnion--Payroll-Deduction-Form.pdf 12.143 KB (Last Modified on January 16, 2018)

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Employee Health and Dental Insurance

Prescriptions - CVS Caremark Mail Service Order Form (90 day only)

CVS Care Mark _Mail Service Order Form.pdf 1.08 MB (Last Modified on May 8, 2019)

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Health and Dental Benefits Overview

OVERVIEW OF HEALTH AND DENTAL 2018-2019.pdf 220.97 KB (Last Modified on October 12, 2018)

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Health Insurance Claim Form

ben-hiclaim.pdf 74.119 KB (Last Modified on January 16, 2018)

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Ameritas Dental Claim Form

Ameritas_Dental_Claim_Form.pdf 112.46 KB (Last Modified on October 15, 2018)

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Ameritas Dental Enrollment Form

026-301517-Dental-Enrollment-Form.pdf 67.721 KB (Last Modified on January 16, 2018)

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Ameritas - Overview of Benefits

Ameritas - Overview.pdf 45.74 KB (Last Modified on April 15, 2019)

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Ameritas/Dental Full-time Student Status Form - 9/14

BB-fitzharris-FULL-TIME-STUDENT-STATUS-092014.pdf 122.795 KB (Last Modified on January 16, 2018)

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Take Care (WageWorks) Health Care Account Claim Form

TCWW-ClaimForm-UnreimMedical.pdf 159.83 KB (Last Modified on May 15, 2019)

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Take Care (WageWorks) Dependent Care Account Claim Form

TCWW-ClaimForm-DepCare.pdf 196.22 KB (Last Modified on May 15, 2019)

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Prescriptions - CVS Caremark Non-Medicare Reimbursement Form

CVS-Caremark-Non-Medicare-Mail-Order-Form.pdf 638.467 KB (Last Modified on January 16, 2018)

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Prescriptions - CVS Caremark Silverscript Medicare Reimbursement Form

CVS-Caremark-SilverScripts-Medicare-Mail-Order-Form.pdf 569.898 KB (Last Modified on January 16, 2018)

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CVS Care Mark ID Card for active and non Medicare retirees

CVSCaremark-IDcard-for2014-forActive-and-NonMedicareRetirees.pdf 45.172 KB (Last Modified on January 16, 2018)

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Silverscripts ID Card for Medicare Retirees

SilverScripts-IDcard-for2014-forMedicareRetirees.pdf 112.091 KB (Last Modified on January 16, 2018)

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403(b) Retirement Plan

403(b) Contribution Limit 2022 Memo

403b Contribution Limit 2022 - Memo.pdf 31.71 KB (Last Modified on December 9, 2021)

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OMNI Update 4th Quarter 2020

OMNI-Updates-4th-Qtr-2020_74.pdf 967.56 KB (Last Modified on November 10, 2020)

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403(b) Retirement Plan

OMNI 403B.pdf 199.33 KB (Last Modified on January 13, 2021)

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403(b) Universal Eligibility Notice

East Ramapo CSD UA Notice_2020.pdf 1.79 MB (Last Modified on January 30, 2020)

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403(b) Authorized Agents

2019 403b Authorized Agents.pdf 72.5 KB (Last Modified on December 4, 2019)

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403(b) Retirement Plan Document

403b_Retirement_Plan_Document.PDF 1.25 MB (Last Modified on September 17, 2018)

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OMNI 403(b) Form

OMNI 403B.pdf 199.33 KB (Last Modified on January 13, 2021)

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