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Medical/Vision/Dental Forms

- United Health Care Enrollment/Change/Cancellation Request - 48kkb

- UHC Plan M2F 500 - 654kb

- UHC Plan M2G 1000 - 2.6MB

- UHC Plan 5MV 3000 - 2.7MB

- Guardian Dental Plan - 40kb

- VSP Vision Plan - 35kb

 

Vacation Plan Forms

- 2009 Vacation Letter/Policy - 279kb

- 2010 Vacation Letter/Policy - 81kb


Startup Forms

The following is a detailed listing of enrollment forms necessary to enroll with Delta Staffing's payroll company, DEM Group, L.L.C., Inc.

All forms in bold are government or state mandated. If DEM Group, L.L.C., Inc. does not receive completed forms; we will be unable to process any payroll checks due to Federal and State laws.

- New Employee Startup Packet - 1003kb
(A single PDF of all necessary forms)

Individual Startup Packet Forms
Form Name How To Complete PDF
New Hire Information Form - Complete Appropriate Sections - 537kb
Employee Acknowledgment - Read, Sign and Date - 274kb
Form W-4 - Fill in name, address, and SS# in Lines ! & 2
- Check a box in Line 3
- Fill in number of dependents in Line 5
- Sign and date form
- Second sheet used to calculate for itemized returns and for employees with multiple jobs
- (Do note use this if this does not apply to you)
- 226kb
State of Michigan Employee Withholding Exemption Certificate - Follow Instructions - 58kb
U.S. Department of Justice Form I-9 - Complete Section 1 including signature and date
- Provide proper identification for your manager to complete Section 2
- 317kb
Co-Employee Notice and Agreement - Read, sign and date agreement - 112kb
Policy Against Harassment and Discrimination - Read, sign and date - 145kb
Direct Deposit of Payroll Form *** Optional ***
- Fill in all information for each account
- Attach voided check
- Sign and date form
- 178kb
Employee Holiday Fund - If interested, fill in information and fax/mail to DEM - 175kb
Flexible Spending Account Program Overview - Provides important details about this tax savings plan
- Read Information prior to completing the FSA Election Form
- 88kb
Flexible Spending Account Election Form - Complete the FSA Election Form
- To elect Medical FSA, fill in election amounts
- To elect Dependent Care, fill in election amounts
- Sign and date the form
- 79kb
     

 

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Delta Staffing
5730 Bella Rosa Blvd Suite #300
Clarkston, MI 48348

Local: (248) 394-3940
Toll Free: (866) 39-DELTA
Toll Free: (866) 393-3582
Fax: (248) 479-5010
recruiter@delta-staffing.com
sales@delta-staffing.com

 


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Delta Staffing 5730 Bella Rosa Blvd Suite #300 Clarkston, MI 48348 | Local: (248) 394-3940 | Toll Free: (866) 39-DELTA |(866) 393-3582 Fax: (248) 479-5010