Employee Forms

Plattsburgh City School District > Employee Forms

District Quick Links

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IRS Form W-4 This link will open in a new tab.
Finger Printing Procedures This link will open in a new tab.
ID Badge Request This link will open in a new tab.

Health Insurance Plan Information

CEWW Health Insurance Consortium Page This link will open in a new tab.

Cancer Screening Form

Cancer Screening Form Part 1 and 2 This link will open in a new tab.

Contact for Health Insurance Inquires

For additional questions please contact

Lynn Wang – Benefits
(518) 957-6004 | lwang@plattscsd.org

403(b)

OMNI 403 (b) Retirement Savings Plan website This link will open in a new tab.
403(b) Universal Availability Notice This link will open in a new tab.

Preferred Group Flex Spending Account Benefit Forms

Change_of_Status Form This link will open in a new tab.
Claims submission guidelines-Expense Listing This link will open in a new tab.
Direct Deposit Form This link will open in a new tab.
Flex Brochure 2011 This link will open in a new tab.
Flex Spending Voucher This link will open in a new tab.
Flex Tax Break Tri Fold This link will open in a new tab.
FSA Video Flyer
Guidelines for the use of OTC This link will open in a new tab.
PG Section 125 Benefit Termination from Service Form This link will open in a new tab.

Contact for Retirement Inquires

For additional questions please contact

Kristina LaDuke – District Treasurer
(518) 957-6007 | kladuke@plattscsd.org