Part-Time Benefited Employee New Hire Paperwork

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The following links show the required (and optional) new employee paperwork for your review/use. To complete the forms, click the form name. After completing the forms, print, sign and bring the forms with you on your first day of employment to the Human Resources Office. 

NOTE: For security reasons, please do not email completed new employee forms to the City.

Required Forms

The Part-Time Paperwork Checklist [PDF] recaps all the documents you will need to print/fill out as part of the new hire process. 

Arizona State Retirement System (ASRS) is a defined benefit plan. It provides a lifelong benefit based on years of service earned, or worked, and your ending salary. As a condition of your employment, you are required to participate in the Arizona State Retirement System. We will complete your enrollment for ASRS on your first day.

As a new member of ASRS, if you have any questions regarding what ASRS is and how much you’ll be contributing, please follow these links: https://www.azasrs.gov/content/new-and-prospective-members https://www.azasrs.gov/content/contribution-rates


Arizona Minimum Wage Law [PDF]

Arizona State Tax [PDF]

At-Will Acknowledgement Form [PDF]

Computer Use Policy and Acknowledgment [PDF]

Emergency Notification [PDF]

Federal Tax [PDF]

Loyalty Oath [PDF] - Must be signed/witnessed in Human Resources on your first day

Wage Withholding Request [PDF]

Cash Pay Card & Direct Deposit Form [PDF]

After completing all the required paperwork above you will have all the documents you need on your first day of employment with the City of Mesa. In order to be completely prepared, please be sure to use the checklist referenced above in the Required Forms section. 

 

Benefits

All documentation needed for benefits are due the first day of employment. You will be required to provide appropriate documentation based on your benefit elections such as marriage certificate, birth certificate(s), social security numbers, etc. A list of enrollment verification documentation and a checklist can be found in the New Hire Benefits Workbook. You will also need to designate a beneficiary for your Basic Life, AD&D, and commuter insurance. Please be prepared with the beneficiary name, address, date of birth, and social security number. For more information on benefit plans please visit Employee Benefits or contact the office at (480) 644-2299 or via email at Benefits.Info@mesaaz.gov.  Please also review the Federally Mandated Notices.

Effective Date Overview  

If you are electing same day benefit coverage (the employee's start date) you MUST be prepared with all required documentation and complete your elections online during orientation on your first day of employment. Otherwise your benefits coverage start date will be the first of the following month.   

City of Mesa Health Benefit Options

City of Mesa Voluntary Benefit Options

Deferred Compensation - 457 (b) Plan (Optional)

As a full-time employee, you are eligible to participate in the City's Deferred Compensation Program.  Enrollment into this program can be done at any time during your career with the City, including your first day of employment.