Forms
- Accounts Payable Forms
- Benefits Forms & Instructions
- Employee Separation Form
- Employee Status Change Form
- Facilities Rental Forms
- Fundraiser Forms
- Leave of Absence Forms
- Payroll Forms
- Print Shop Forms
- Risk Management Forms
- Travel Forms
Accounts Payable Forms
Code Correction Form (updated 10/22/2021)
Deposit Correction Form (updated 4/14/2021)
Interdepartmental Transfer
Intouch Revised Deposit Form (updated 10/14/2020)
Waived Fee Form
Benefits Forms & Instructions
Claim Forms & Instructions
Accident and Critical Illness (The Standard)
Accident Benefits Claim Packet
Critical Illness Benefit Claim Packet
Health Maintenance Screening Benefit
Group Accident Insurance Certificate
Group Critical Illness Insurance Certificate
Cancer Insurance (Loyal American)
Dental Insurance (The Standard)
Disability Insurance (The Standard)
Short Term Disability FAQ about Filing a Claim
(Claims after 9/1/21)
Long Term Disability FAQ about Filing a Claim
(Claims after 9/1/21)
Disability Claim Filing Instructions
(Claims before 9/1/21)
Disability Claim Packet
(Claims before 9/1/21)
Disability Claim Packet Spanish
(Claims before 9/1/21)
Authorization to Release Information
(Claims before 9/1/21)
Hospital Indemnity (Met Life) for services prior to 4/1/23
Hospital Indemnity Claims Process Flyer
MetLife Benefits Login:
Mesquite Independent School District
How to access your Certificate of Insurance Online
Hospital Indemnity (Standard) Effective 4/1/23
Health Maintenance Screening Benefit
Life Insurance (Fidelity)
MedBridge (Gap) Insurance (Colonial Life)
Vision Insurance (VSP)
Forms and Instructions for Name and Beneficiary Changes
Name Change Forms Request - Google Doc
Name/Beneficiary Change Instructions
403(b) Name/Address Change Form
Cancer Name/Beneficiary Change Form
Chubb/Combined Insurance Beneficiary Change Form
Direct Deposit Authorization Form
FidelityLife Beneficiary Change Form
HSA Bank Account Designation of Beneficiaries Form English
Cuenta de Ahorros Médica (HSA) Formulario de designación de beneficiarios (HSA)
HSA Bank Account Information Change Form (Name/Address Change)
MEA Name/Beneficiary Change Form
MISD Final Paycheck Beneficiary Form
Formulario de Beneficiario del Último Pago
RAMS FICA - Designation of Beneficiary
Social Security Application for SS Card
Texas Life Beneficiary Change Form
Texas Life Request for Name Change Form
TRS Change of Address Notification Form
Other Forms
Health Insurance Forms
BCBS Health Insurance Forms Website
HSA Bank Forms
HIPAA
Mesquite ISD Cancellation Request
Mesquite ISD Cancellation Request Form
- Complete this form to stop your
- annuity (403b, 457) contribution
- Lone Star 529 Plan contribution
- CHUBB Lifetime Benefit Term policy
- Fidelity Life Insurance policy
- Standard Bundler policy (Accident/Critical Illness)
- Standard Term Life Insurance policy
- Payroll change is effective 1st of month following date request is received in Benefits Office.
The Standard Insurance Forms
- Complete this form if you wish to obtain or increase life insurance coverage during a benefits open enrollment opportunity.
- Select your State of Residence and Language Preference (English or Spanish).
- Name of Group: Mesquite ISD
- Group Number: 648015
- Type of Application:
- Initial (DO NOT SELECT THIS OPTION during an open enrollment opportunity; this option is for NEW HIRE enrollment)
- Increase in Coverage (if you are increasing your current life insurance amount more than $10k or over Guarantee Issue Amount)
- Late Application (if this is your initial enrollment for life insurance)
Employee Separation Form
Employee Status Change Form
Instructions for Completing Employee Status Form
Important note: you must have Adobe Acrobat Reader installed on your computer to complete the necessary digital signatures on this form. Adobe Acrobat and Ereader will not support the digital signature. You will not be able to complete the signature portion on the document without Adobe Acrobat Reader.
This document must be completed and submitted electronically. You may not print and scan the document. If you do not have Adobe Acrobat Reader you will need to submit a request to install the program to help desk.
This form is NO LONGER for any type of employee separation. See above for new Employee Separation Form.
It is also NOT for Name Changes – use this form for name changes.
- Download and Save the form to your desktop or preferred folder
- Open the form in Adobe Acrobat Reader
- Complete all the blue fields at the top of the form and make sure you complete the "Replaces" and "Effective Date of Change" fields. Pink fields are optional. All YELLOW and GREEN Fields are for Personnel use ONLY. Employee Signature is optional. Supervisor Digital Signature is REQUIRED.
- Once the form is complete and digital signature is added, save the form to your desktop or preferred folder as: "employeename_StatusChangeForm_date"
5. EMAIL the form to the appropriate personnel director:
- Paraprofessionals - Kellie Haddock
- Elementary Professionals - Larry Sanford
- Secondary Professionals - Emilio Duran
- Auxiliary - Kyle Holcomb
Click the following button to download the electronic, fillable Employee Status Change Form.
Facilities Rental Forms
Fundraiser Forms
Leave of Absence Forms
Leave of Absence
A leave of absence request must be completed if an employee will be absent for 5 or more consecutive days. The request for a leave of absence should be completed and submitted by using the Mesquite ISD Request for Leave form located on Eduphoria.
- Log into Eduphoria.
- Select formspace on the left side of the page.
- Select Submit New Form in the bottom left corner of the page.
- Select Personnel Forms.
- Select Leave Request Form and complete the online form.
All Auxiliary employees should request a leave of absence form from their department supervisors, campus administrator or the Auxiliary Personnel department.
Payroll Forms
W-4 Form (IRS Website)
Direct Deposit Form
Credit Union of Texas Payroll Deduction Authorization
Absentee Report
Elementary Teacher Subbing
Elementary Para Covering Class
Middle School Teacher Subbing
Middle School Para Covering Classes
High School Teacher Subbing
High School Para Covering Classes
Department Extra Duty Sheet
Print Shop Forms
Risk Management Forms
ADA Request (Updated October 2022)
Approved Bounce House (Updated October 2022)
Authorization to Transport Students (Updated August 2022)
First Report of Injury (updated July 2022)
First Report of Injury Written Statement (added July 2022)
Vehicle Accident Report (Updated October 2022)
Travel Forms
Travel Form (updated Feb. 2023)
Federal Travel Form (updated Feb. 2023)
Blue Travel Sheet (updated Feb. 2023)
Hotel Occupancy Tax Exempt Form