Payroll Forms

If you have any questions please contact:

Eleneth Reyes


201-302-5200 Ext-1208 I Fax – 201-461-0218

Ameriflex — Flexible Spending plans

Dental Enrollment Forms — Dental enrollment form. A new form needs to be filled out when (birth, marriage, divorce) occurs. Summary of Benefits –what is covered under the dental plan

Health Forms — Health Benefits/Enrollment Form/Plan Summaries

Payroll/Direct Deposit Directions — Please click on the link, login with your Leonia Google account to access the Payroll/Direct Deposit Directions. Thank You.

Plan Connect 403b Salary Reduction Agreement/Plan Advisors — 403b/457b salary reduction agreement form List of all 403b/457 plans and advisors

W4 Form — All new hires need to fill this out to be paid. A new W-4 should be filled out for marriage, birth, divorce.