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City of Hamilton

Human Resources Forms - For Current City of Hamilton Employees Only

Many of the forms that you may require are available here. If you require a form that is not listed here, please contact your supervisor or your departmental contact in Human Resources.  These forms are in PDF format.  Adobe Acrobat is required to read them. 

Assignment of Paramedical Practitioners
Use this form to assign benefits to your paramedical practitioner (practitioner to receive payment directly from Manulife Financial).  Original receipts must be attached for all expenses.  A separate Assignment of Benefits form must be completed for each provider.
 
Assignment of Vision Care Claim
Use this form to assign benefits of vision care claims (provider to receive payment directly from Manulife Financial).  Original receipts must be attached for all expenses.  A separate Assignment of Benefits form must be completed for each provider.

Authorization for Payroll Deductions (Employee Charity Fund)

The City of Hamilton has set up an Employee Charity Fund that anyone can participate in, if desired.  This form allows the City to automatically deduct the desired contributions from an employee’s paycheck.  Employees can fill out this form in the Human Resources Department, 120 King St. W. 9th Floor and it will be sent to the Payroll Section.

Canada Savings Bond (CSB Change Form)
This form is used when an employee wishes to increase or reduce his/her contributions to the Canada Savings Bond Purchase Plan.  The form is to be completed by the employee and submitted to the Financial Services - Payroll Division.

Computer Purchase Plan
The program provides an interest-free loan (minimum of $1,000 - maximum of $2,000) repayable over 12, 24 or 36 months, for the purchase of computer equipment for home use.  For more information about this program, click here.

Dental Claim Form
Claimants requiring reimbursement for dental care expenditures must have this form completed by their dentist, or dental specialist.  Original receipts and applicable supporting documentation must accompany all claims submissions.  The completed form and receipts may be forwarded directly to Manulife Financial. 

Direct Deposit of Your Pay
Use this form if you wish to change your pay deposit banking information.  Submit the form to your payroll contact at least 10 days prior to your next pay.  We would suggest that you keep your old account open until  you see your pay being deposited into the new account.

Employment Income and Verification
To request this record, log on to My HR Info from any computer at work.  Once logged in, click "My Pay".  If you do not have computer access at work, call and request this statement from the payroll contact for your department.

Prescription Drugs, Prosthetic Appliances & Medical Equipment: Extended Health Benefits Claim Form
Claimants seeking reimbursement for extended health care benefits such as prescription drugs can complete this form and submit it by mail or in person to the address listed on the form.  Original receipts and applicable supporting documentation must accompany all claims submissions.  The completed form and receipts may be forwarded directly to Manulife Financial. 

Mileage & Other Expenses Form
This form is to be completed by an employee requesting compensation for accrued mileage and other related expenses.  The completed form should be submitted and approved by the related department and forwarded to Accounts Payable in Corporate Services.  Mileage reimbursement information is contained in collective agreements for unionized, and in the compensation policies for non-union employees.

Overtime Payment
This form is used to request payment of time worked above your designated work week and must be approved by your supervisor.  For details on overtime policies, unionized employees should consult their collective agreement.  Non-unionized employees may refer to the non-union compensation policies.

Over Age Dependent Student Form
Use this form to extend your benefits coverage to your over age children that are under 25 years age, unmarried and unemployed but attending school, college or university full-time.  This form must be completed in August of each year.  Return the completed form to your Benefits Administration contact in Human Resources.  Please note that proof, in the form of an original letter from the Registrar’s Office stating the semester dates and indicating a full time enrolment status must accompany this form.

Request for Hard Copy of Pay Advice
Hard copy pay advices will no longer be printed as of January 20, 2006.  Pay information is available on My HR Info.  If you DO NOT have Internet access at work or at home, hard copy pay advices are still available.  This form is used to request hard copy of pay advices. 

Request for Record of Employment 
This form may be required to obtain benefits such as employment insurance. 

Short-Term Disability Form (Non-union) / Short-Term Disability  Form (CUPE 5167 & 1041) / Short-Term Disability Form (ONA) / Short-Term Disability Form (OPSEU) / Short-Term Disability Form (ATU)
If you’ve been off work due to illness or injury for six days or more, you and your physician are required to complete this form. The form is to be submitted to Return to Work/Work Accommodation Services in Human Resources.  Click here for your HR contact.  More information on returning to work from an absence is available here.

T4/T4a Re-issue Request
To request this record, log on to My HR Info from any computer at work.  Once logged in, click "My Pay".  If you do not have computer access at work, call and request this statement from the payroll contact for your department.

Vacation Pay Out Form 
This form is to be completed for the request of “pay out for vacation” by an employee and requires the General Manager’s signature.  The completed form must be submitted to the Human Resources department, 120 King St. West, 9th Floor.

Vacation Carry-Over Form 
Complete this form if you wish to carryover vacation time from one year to the next.  It requires the signature of the General Manager.  The City of Hamilton believes in the value of vacation time and encourages all staff to take their yearly entitlement each calendar year.

Voluntary Leave of Absence Form
The Voluntary Leave of Absence Program allows full-time employees (except those on probation) to apply for up to 20 days of unpaid leave without impact to the benefits and vacation entitlements that they currently receive.  Full details about the program are available here.