Central Payroll Bureau

Questions?
Contact Us

Sally A. Mercer
Director of Human Resources

Melvin A. McClintock
Assistant Director of Human Resources/AA/EEO Officer

Michelle L. Forinash
Payroll/HR Administrator

A. Faye Graves
Human Resources Specialist

Symaria A. Enoch
Fiscal Associate II

Rannieta T. Rothwell
Office Associate II

Phone: (240) 895-4309
Fax: (240) 895-4997
18952 East Fisher Road
St. Mary's City, MD 20686

Forms, Contracts, and Payroll

The forms linked to, unless otherwise indicated, are in PDF format and may be viewed using Adobe Acrobat Reader. Most of these forms also have been formatted with a fill-in feature that allows you to type information into them on your computer and then print out a paper copy. If you are having problems viewing ADOBE.PDF files, please view our special instructions.

NOTE: All completed forms should be returned to the Office of Human Resources for processing.

Forms

• Address Change - Health Benefits
• Address Change - Payroll
• Aetna Vision Claim Form
• Affidavit of Eligibility of Coverage for Legal Wards, Grandchildren, and other Dependent Child Relatives
• Affidavit of Eligibility of Coverage for Stepchildren
• Affidavit of Tax Status of Dependent Children
• Care First Blue Cross Blue Shield Health/Vision Plan Claim Form
• Dependent Care Reimbursement Claim
• Disciplinary Formal (Oral) Warning
• Disciplinary Suspension
• Disciplinary Warning
• Faculty Sick Leave Request Form
• Grievance and Appeal
• Grievance and Appeal for Non-Union Employees
• Healthcare Reimbursement Claim
• MAMSI Vision Claim Form

Contracts

• Contractual Administrative Services Agreement
• Contractual Faculty Services Agreement

Payroll

• Regular Payroll
  • Admin/Staff: Leave Request
  • Essential Administrative Pay
  • Faculty: Sick Leave Request
  • Regular Payroll Schedule 2008
• Contractual Payroll
  • 311 Admin Form
  • 311 Faculty
  • 311 HSMC Admin
  • 311 HSMC Staff
  • 311 Staff
  • 311 Student
  • Contractual Payroll Instructions
  • Contractual Payroll Schedule 2008
• General Payroll
  • Computer Usage
  • Direct Deposit Form
  • Drug Test Non-Sensitive Letter and Acknowledgement
  • Drug Testing Policy - HSMC
  • Essential Administrative Pay
  • I-9 and Instructions (Print double sided)
  • Maryland New Hire Registry HSMC
  • Maryland New Hire Registry SMCM
  • Overtime Form
  • Questionnaire
  • Savings Bonds Form
  • Savings Bonds Instructions
  • Software Code of Ethics
  • Substance Abuse Policy
  • Substance Abuse Policy Acknowledgement
  • W4 MD 2008
  • W4 D.C. 2008
  • W4 WV 2008
  • W5 2008 Earned Income Credit Advanced Payment Certificate