Human Resources Kami Perkins Human Resources Director 90 North Main Street Tooele, UT 84074 Phone: 435.843.2105 Fax: 435.843.2106 Quick Links Menu Human Resources Home Page 2019 Open Enrollment Open Enrollment Newsletter & PEHP Packet Summary of Benefit Coverage & Notices Flex Account Enrollment Form Health Insurance Waiver Health Saving Account Enrollment (HSA) Form Medical and Dental Enrollment and Change Form Benefits Compensation EEO Employee Portal Benefits and Benefit Provider Links Benefit Provider Links Electronic Time Card Electronic Time Card (Manager Access) Forms, Calendars and Schedules Personnel Policies & Procedures Required Notices of Employee Rights Forms, Calendars and Schedules Job Openings Personnel Policies & Procedures BreadcrumbsHome > City Departments > Human Resources > Human Resources Forms, Calendars and Schedules Human Resources Forms, Calendars and Schedules - 2019 Pay Period Schedule - 401K Change Form – John Hancock - Absentee Request - Address Change Form - Appendix D – Dust Mask Use - Application for Leave (use for FMLA or LOA) - Change in Status - Confined Space Entry Permit - Direct Deposit Form - Disclosure Statement – Conflict of Interest - Education Reimbursement Application - Emergency Contact Information - Employment Applications - Expense Report - Flexible Spending Account Enrollment Form - Flexible Spending Account Worksheet - Flexible Spending Account Reimbursement - FMLA Cert of Health Care for Employee - FMLA Cert of Health Care for Family - FMLA Cert of Qualifying Exigency for Military - FMLA Cert Serious Injury / Illness of Service Member - Grievance Form - Health Insurance Waiver Form FY2020 - Health Savings Account Enrollment - I-9 - Incident Investigation Form - Incident Report Form - Life Insurance Beneficiary Form - Life Insurance Enrollment Form - Line of Duty Beneficiary Form - Mail Order Pharmacy Form - Medical and Dental Enrollment & Change Form - Mutual of Omaha Change Form - Mutual of Omaha Designation of Beneficiary - Mutual of Omaha Enrollment Form - Out of State Travel (Advanced Request) - PEHP COB Reimbursement - Personnel Requisition Request - Reasonable Suspicion Checklist & Instruction Sheet - Retirement Change Form - Salary Schedule FY2020 - Separation Notice and Exit Interview - Short-Term Disability Insurance Claim - Time Card - Travel – Overnight In-state - URS Beneficiary Change Form - Vision Claim Form - Vision Enrollment Form - W-4 (2019) Site Shortcuts: Quick Telephone Directory (435) 843-2152: Accounts Payable (435) 843-2104: Administration (435) 882-4607: Animal Control (435) 882-4607: Animal Shelter (435) 843-2120: Attorney (435) 843-2131: Building Safety (435) 882-4241: Cemetery (435) 843-2110: City Council (435) 843-2130: City Shop (435) 843-2130: Code Enforcement (435) 843-2187: Communities That Care (435) 843-2130: Community Development (435) 843-2100: Departments not listed (435) 882-5600: Dispatch a Police Officer (435) 843-2104: Economic Development/RDA 911: Emergencies (435) 843-2130: Engineer (435) 843-2150: Finance (435) 882-4220: Golf Course (435) 843-2105: Human Resources (435) 843-2260: Information Systems (435) 843-2130: Land Use (435) 882-2182: Library (435) 843-2104: Mayor (435) 843-2142: Parks and Recreation (435) 843-2154: Payroll (435) 843-2130: Planning and Zoning (435) 882-8900: Police Business Office (435) 882-5600: Police Dispatch 911: Police Emergencies (435) 882-3247: Pratt Aquatic Center (435) 843-2130: Public Works (435) 882-2836: Railroad Museum (Summer Only) (435) 843-2110: Recorder (435) 882-1591: Shops (435) 843-2137: Streets (435) 882-3247: Swimming Pool (435) 843-2108: TDD (435) 843-2105: Treasurer (435) 843-2150: Utilities (435) 843-2130: Wastewater Treatment (435) 843-2130: Water | How do I... Apply for a job? Apply for Special Event Permit? Contact the Mayor or a member of the City Council? Get a business license? Pay my utility bill? Report a concern? Reserve a park pavilion or register for an activity online? View City Council Agendas & Minutes? Request copies of public records (GRAMA)?