Forms

Please see the links below to access a variety of forms for your convenience.  Feel free to contact HR if you have any questions about these forms.

The City of Fort Dodge recognizes the value of volunteer service in our community and therefore rewards City employees who volunteer with personal holiday hours! The maximum number of personal holiday hours that can be earned in a calendar year are are eight (8) hours.  Click here for the Volunteer Work Verification form and submit your completed form to HR for credit.     

If you're participating in the Blue Priority Flex Plan and need to submit a request for reimbursement, please complete the Flex Request for Reimbursement form and provide supporting documentation, as indicated on the form.

Have you changed banks? Or would you like a portion of your paycheck to be deposited into a specific account, such as your savings?  If so, simply complete a Direct Deposit Form and turn it in to HR or the Clerk's Office.

Have you experienced a life change such as marriage, birth, adoption, divorce, etc.?  If so, please use the forms below to update your information.

Medical & Dental updates:
Wellmark Blue Cross Blue Shield Change Form
Delta Dental Change Form
Flex Savings Account Form
HSA Election Contribution Form

Beneficiary Changes:
The Hartford Life Insurance Beneficiary Designation
IPERS Enrollment/Beneficiary Form
Municipal Fire and Police Beneficiary Designation
HSA Designation of Beneficiaries Form


If you feel you're being discriminated against or harassed by someone at work, please complete the form below or stop into HR to report it.    
Discrimination - Harassment Complaint Form


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