William J. Rothaar - Financial Administrator - Ext. 270


Phone (631) 727-3200
Fax (631)727-4230
1295 Pulaski Street
Riverhead, NY 11901
    Monday - Friday - 8:30 a.m. - 4:30 p.m.


Carol Del Vecchio, Payroll Supervisor,  Ext. 217
Joan Mottern, Account Clerk Typist, Ext. 285


                   Forms for Employee Related Services:

                   Cancer Screening Leave Form
                   Direct Deposit Form
                   Dental Plan Benefit Booklet – Metlife
                   Dental Claim Form – Metlife
                   Empire/United Health Care Online Provider Directory
NEW
                   Empire Claim Form
                   Employee Accident Form
- Please Complete and send to Jean Miloski
                   Employment Application
                   Federal Withholding Form - W-4
                   HIP - Vytra Healthcare Link
                   New York State Deferred Compensation Link
                   New York State Retirement System
NEW
                   Payment Claim Voucher
                   Purchase Requisition
                   Section 125 – Flexible Benefit Plan
                   Sick Bank Membership Application
                   Sick Bank Request Application
                  
Sick Buy Back Form - CSEA
                   Sick Buy Back Form - PBA
                   Sick Buy Back Form - SOA

                   State Withholding Form - IT-2104
                  
Vacation Buy Back Form - CSEA
                   Vacation Buy Back Form - SOA

                   Vision Plan Benefit Explanation – Cole
                   Vision Claim Form – Cole
                   Vision Claim Form – Cole - Out of Network

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