Employee Forms

EMPLOYEE FORMS
Human Resources > Employee Forms

Human Resources
Employment
Job Opportunities
Employee Benefits
Employee Forms
Required Notices
Policies and Procedures
Union Contracts

New Hire Forms:
Federal W-4 Form
State WT-4 Form
I-9 Instructions and I-9 Form
Direct Deposit
Message to New Hires: Congratulations on your new position with the City of Wisconsin Rapids! Please complete the above forms and bring these forms with you to new hire orientation on your first day of work. Remember to bring your form(s) of ID with you for the I-9 Employment Verification – please see Page 2 of the I-9 Form for the list of approved documentation options. We look forward to working with you.

FMLA Forms:
FMLA questions and forms can be directed to Sarah Anderson - [email protected]
Medical Certification - Employee
Medical Certification - Family Member
FMLA Application
FMLA Employee Rights
FMLA Policy
FMLA Checklist

Leave of Absence:
Leave of Absence Request Form

Military and National Disaster Leave:
Military Leave and National Disaster Form

Insurance Forms:
(Please return forms to HR)
Dental Enrollment/Change Form
Medical Enrollment Form
Medical Change Form

Payroll Forms:
(Please return forms to Payroll)
HSA Payroll Deduction Form - 2025
DBS FSA Enrollment Form (Dependent Care Only)
Direct Deposit Application - FSA
Online Set-Up - FSA
Payroll Action/Time Off Form

Other Forms:
If you have an employee who is involved in an accident with a City-owned vehicle, please take the following steps immediately:

Complete the Injury Report and Accident Property Damage report.
Call HR - we will inform Aspirus Occupational Health that a City employee will be coming in for post-accident drug and alcohol testing.
Immediately escort the employee to Aspirus Occupational Health (Riverview Hospital). Occupational Health is located on the second floor.
If the accident is after hours, take the employee to Aspirus ER. Inform ER personnel that we need a post-accident drug and alcohol screen.
Direct Aspirus to forward all test results to HR.
Forward the completed accident reports to Karen Timm in the Finance Department with copy to HR.

Injury Report

Instructions: Please complete this form if you are injured at a work within 24 hours of your injury. When this form is completed, please forward it to your immediate supervisor. Managers - HR must receive this form as soon as possible in order to report this to the Workman's Compensation carrier. Our carrier requires early reporting for compliance reasons. Please submit this completed report to Sarah Anderson and Jill Kremer.

Accident & Property Damage Report
Referral Form
Requisition & Position Needs Analysis
Tuition Form