City of Grand Haven
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Forms

Below are forms for employee use.  Please complete and submit to HR or Finance.  Please feel free to email to Amanda Burnett. 

Injury

Blood & Bodily Fluid Exposure Worksheet

Injury Flow Chart

Injury Report Form

 

Payroll

457 Enrollment & Change Form

Credit Card Authorization Form

Direct Deposit Change Form

Federal W-4

HSA Contribution Change Form

IRA Contribution Change Form

MI W-4

Time Off Request Form

Overtime Request Form

 

FSA

FSA Mandatory Statement for Dependent Care

Retirement

457 Enrollment & Change Form

IRA Application

IRA Contribution Change Form

Visit mersofmich.com to apply for retirement

FMLA

FMLA Cert For Family Member Serious Health Condition

FMLA Cert for Employee Serious Health Condition

How to File Your Disability Claims

Tuition Reimbursement

Form 1: Submit Prior to Course Starting

Form 2: Submit After Grades Received

Contact Us

Grand Haven City Hall
519 Washington Avenue
Grand Haven, MI 49417

MAP LOCATION

Main Office Hours
Monday – Friday
8:00am to 5:00pm

Main Phone
616-842-3210

City Employee Login

Employee Self Service

POPULAR RESOURCES

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DIRECTORY

AGENDAS

PROJECTS OUT FOR BID

BILL PAYMENT

GENERAL CONTACT

TITLE VI NON-DISCRIMINATION

COMMUNITY SERVICES

BOARD OF LIGHT & POWER

THE CHAMBER

HARBOR TRANSIT

GH AREA PUBLIC SCHOOLS

GH COAST GUARD FESTIVAL

GH MUSICAL FOUNTAIN

 

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