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City of Omaha - Nebraska

City of Omaha Human ResourcesOmaha, Nebraska

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The links on this page are to the forms commonly used to update/select your benefits due to a qualifying event or submit a compensation adjustment (usually for working out of classification or rank). 

Adjust Work Schedule - Functional.pdf 

Adjust Work Schedule.pdf 

Alegent - Creighton EAP.pdf 

BCBSNE Rx Mail Order Form.pdf

Beneficiary Update Form.pdf 

Bi-Weekly Mileage Form.pdf

Cell Phone Allowance Request Form

Employee Assistance (EAP) Referral Form.pdf 

Flexible Spending Account Enroll 2010.pdf

FMLA Employee Serious Health Condition.pdf 

FMLA Family Member Serious Health Condition.pdf 

FSA - WageWorks Commuter Claim Form.pdf

FSA - WageWorks Dependent Care Claim Form.pdf 

FSA - WageWorks Letter of Medical Necessity Form.pdf 

FSA - WageWorks Medical Care Claim Form.pdf 

FSA - WageWorks Participant Direct Deposit Form.pdf 

Funeral Leave - Management.pdf 

Funeral Leave - Non-Management.pdf 

Funeral Leave - OPD Bargaining.pdf 

Holidays 2015-2018.pdf 

Long Travel Form.pdf 

No Cost Travel Authorization.pdf 

Position Analysis Questionnaire.pdf 

Refund of Pension Contributions - Civilian

Refund of Pension Contributions - Police-Fire

Refund Tax Notice - Civilian

Refund Tax Notice - Police-Fire

Tuition Reimbursement Application.pdf 

Tuition Reimbursement Policy.pdf 

Workers Compensation - Corvel Mileage Form

Workers Compensation - Form 50 - Choice of Physician.pdf

Workers Compensation - Initial Report of Injury on Duty 

Workers Compensation - Investigation Report of Injury or Illness

Working Out of Class Pay Request - Over 30 Days.pdf 

Working Out of Classification-Rank.pdf 

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