Forms

Job Applications

  1. Civil Service Application (PDF)
  2. General Application (PDF)

Public Forms

  1. Authority to Release Private Information Form (PDF)
  2. Grievance Form-Complaint Questionnaire (PDF)
  3. Public Records Request Form (PDF)
  4. Request to Correct or Amend PHI (PDF)
  5. Revocation of Authorization for Use / Disclosure of PHI (PDF)
  6. Violent Act / Threat Report Form (PDF)

Employee Only Forms

  1. Accident-Incident Report Form (PDF)
  2. Authority to Release Private Information Form (PDF)
  3. Change of Name, Address, Phone, Emergency Contact
  4. Direct Deposit Authorization Form
  5. Grievance Form-Complaint Questionnaire (PDF)
  6. Hours Certification Form for Elected and Exempt Employees (PDF)
  7. Public Records Exemption Log (PDF)
  8. Request to Correct or Amend PHI (PDF)
  9. Revocation of Authorization for Use / Disclosure of PHI (PDF)
  10. Sick Bank Donation Form
  11. Sick Leave Conversion Form (PDF)
  12. Violent Act / Threat Report Form (PDF)

Employment Documents

  1. I-9 Form and Acceptable Documents
  2. W-4 2022
  3. IDAHO W4 2021
  4. Whitman County Employee Data Sheet
  5. Direct Deposit Authorization Form
  6. Distribution of Paychecks and Paystubs
  7. Email-Internet Policies acknowledgement
  8. Payroll Deduction Authorization
  9. Employee Safety Security Orientation Checklist
  10. New Employee Checklist 2022

Orientation Policies and Procedures

  1. Overseeing Email Internet Policy
  2. Personnel Policy Summary 2022
  3. 2022 Notice of Leave Policies
  4. Privacy Policy Summary
  5. HIPAA Privacy Notice
  6. EEO Policy
  7. 2022-2023 Equal Employment Opportunity Plan
  8. Work Place Violence policy
  9. Reporting Workplace Violence
  10. Smoking Policy
  11. Maint Drug Free Workplace Policy
  12. Anti-Harassment Policy
  13. Bloodborne Pathogen Exposure Control Plan
  14. Policy Summary Acknowledgements
  15. Confidentiality Statement
  16. Employee Paid Sick Leave Notification
  17. New Hire Clock In Reference Sheet

Orientation - Retirement

  1. DRS Plan Choice Booklet for Plans 2 and 3
  2. LEOFF 2 Handbook
  3. DRS Beneficiary Designation Form
  4. DRS Enrollment Form
  5. 03_Retirement Status Verification Form
  6. PERS Eligibility Review
  7. PSERS EligibilityWorksheet

Orientation - Health Insurance and Voluntary Benefits

  1. 02_Exchange_Notice_081513 - Copy
  2. CHIP Program Notice
  3. Medicare Part D - Creditable Coverage Disclosure
  4. Wellness Notice to Employees
  5. Salary Redirection Agreement
  6. 01_Important Notice to New Employees
  7. Teamster Participant Data Form
  8. DSA Trusteed document
  9. Waiver of Medical Coverage
  10. Lifeflight Enrollment Form 2022
  11. Vendor Contact List
  12. Group Voluntary Life Insurance
  13. Group Voluntary Short Term Disability Insurance
  14. The Standard Group Buy-up Long Term Disability Insurance - Booklet
  15. The Standard Group Voluntary Accidental Death and Dismemberment Insurance Booklet

Orientation - Public Works Employees Only

  1. PW cardholder agreement
  2. DRUG and ALCOHOL BACKGROUND CHECK - CDL
  3. CDL Drug and Alcohol Testing Manual
  4. CDL Manual Acknowledgement
  5. PUBLIC WORKS - Whitman County Public Works - IT Devices

Orientation - Union Documents

  1. UNION Membership Choice form
  2. Teamster Unit Application
  3. NEW EMPLOYEE NOTIFICATION FORM_WC
  4. Union Initiation Fee Deduction Authorization
  5. Teamsters LIfe Insurance Beneficiary form