Office Forms & Reference Items

Office Forms

PDF DocumentFederal W4 (Tax Withholding)
PDF DocumentFreedom of Information Act Affidavit
PDF DocumentHSA Contribution Form
PDF DocumentInjury/Accident Report 
PDF DocumentInjury/Accident- Concentra Autorization For Treatment
PDF DocumentMichigan W4 (Tax Whithholding)
PDF DocumentPersonal Business/Jury Duty Request 
Excel DocumentTime Sheet- SAS Employees
PDF DocumentTime Sheet- PESG Employees
PDF DocumentTSA Purchase Agreement
PDF DocumentTSA Approved Vendor List
PDF DocumentWellness Exam Form

Reference Items

PDF DocumentTotal Benefits Guide

MESSA Medical PAK Summaries:
PAKs A, C, D include: medical, dental, vision, basic life insurance, AD&D coverage and LTD
PAK B includes: dental, vision, basic life insurance, AD&D coverage and LTD. (this is a non-medical PAK)

Dental Coverage: included in each MESSA PAK above
Delta Dental 

Vision Coverage: included in each MESSA PAK above
VSP Vision Care

Voluntary Benefit Options:
PDF DocumentLegal Shield - Legal & Identity Theft Protection
PDF DocumentExtra Life Insurance - Critical Illness & Accident Insurance
PDF DocumentFlexible Spending Accounts - Dependent Care & Health Care