top of page
Welcome to our team!

Add to your smartphone:

- SmartShopper
- LiveHealth Online
- Lark Program
- My Health Dashboard
- Employee Assistance Program (EAP)

Below there are a number of forms that need to be reviewed, completed and returned to the HR Department as soon as possible. Please print out each form, complete each field and finally sign and return the original document.

If you have any questions as you complete the forms contact HR right away.

Thank you and welcome aboard!


Company Information

Please print and complete the following forms and submit them to the Human Resources Department.


Tax form prepared by an employee indicating the employee’s exemptions and Social Security number, and enabling the employer to determine the amount of taxes to be withheld for the employee.


Employment Eligibility Verification (I-9)

The form that is required by the Department of Homeland Security – U.S. Citizenship and Immigration Services to document eligibility for employment in the United States. All new employees, including U.S. citizens, must supply documents to identify themselves and to establish their eligibility for U.S. employment.


Direct Deposit Form

For your convenience, we provide direct deposit. Your paycheck will be automatically deposited into the account(s) you indicate.


Terrorist Form

Employee Handbook

FMLA Employee Rights and Responsibilities

OPERS New Employee Information

OPERS - Request for Change of address or Name Change on Account

Payroll History Record

Benefit Election Form

MVR Release Form

Employee's Withholding Exemption Certificate

Statement Concerning Your Employment Not Covered By Social Security

Ohio Form IT 4NR Statement of Residency

Ohio Withholding

Forms and Information

Personnel Policy Manual

Acknowledgement Belmont County Personnel Policy Manual

Section 10 - Forms

bottom of page