Town Employees

Due to Increased Security all Direct Deposit form will need to be done in Person.

General Employee Forms
Change of Address Form

Federal Tax Withholdings	W-4 2020
MA Tax Withholdings	MA-4
403 -B TSA
Waiver of Health Insurance Coverage	Waiver of Group Coverage
Employee Paystub Log in


Life Insurance Rates	Basic and Voluntary
Life Insurance Enrollment Form	Group Benefits Form
Brimfield Voluntary Life Insurance Handout	Life and Accidental Death & Dismemberment
FY24 Health Insurance Rates	Health Insurance Rates
MIAA Enrollment Form	Health/Dental Enroll
Dental Blue Program 2	Summary of Benefits
MIIA Dental Rollover	Dental Rollover Information
MIIA Dental Fact Sheet	Fact Sheet for Dental Plan
Colonial Life	Accident, Cancer, Disability Insurance

Express Scripts Medicare	Benefit Overview

MIAA Enrollment Form

New Full Time Employee

Employee Eligibility Verification	Form I-9
Federal Tax Withholding	Form W-4
MA Tax Withholding	Form MA-4
New Hire Information Sheet
Retirement Enrollment Form	New Member Enrollment Form
Social Security Form	Statement Concerning Your Employment in a Job Not Covered by Social Security
Welcome Letter & Instructions

New Part-Time Employee

Employee Eligibility Verification	Form I-9
Federal Tax Withholdings	Form W-4
MA Tax Withholdings	Form MA-4
Nationwide OBRA	OBRA/PST Acknowledgement Card
New Hire Information Sheet
Social Security Form	Statement Concerning Your Employment in a Job Not Covered by Social Security
Welcome Letter & Instructions	Part-Time Employee

Contact Info

Phone:

(413) 245-4100 Ext. 1109 Treasurer
(413) 245-4100 EXT 1106 Tax Collector

Fax:

(413) 245-4107

Address:

Treasurer-Collector

23 Main Street

PO Box 30

Brimfield, MA 01010

United States

See map: Google Maps

Key Contacts

Madeline Goodrich

413-245-4100 EXT 1109

413-245-4100 EXT 1106