Forms

The following forms are provided as a service of the Office of Administrative Services Human Resources Section.

Note:
Use these links to forms to maintain the latest, most accurate version of these forms. Forms that are not the most current version may be returned to your office or unit.

Title	Posted
80-hour Biweekly Exception Timesheet	09/25/2009
AASIS Information Confidentiality and Security Agreement	08/27/2009
ADA Public Complaint	08/19/2009
Address Change	08/20/2009
Applicant Selection Record	08/24/2011
AR4EC	02/02/2011
Bank Details - Direct Deposit	08/24/2011
Catastrophic Leave - Application for Benefits	01/03/2012
Catastrophic Leave - Dependent Child Certification	08/24/2011
Catastrophic Leave - Donor	01/03/2012
Catastrophic Leave - Liability Agreement	01/03/2012
Catastrophic Leave - Physicians Certification	01/03/2012
Catastrophic Leave - Return of Accrual Leave Transmittal	08/24/2011
Change In Employment Status	05/24/2010
Change in Employment Status Instructions	05/24/2010
Code of Ethics - Attachment A	02/18/2010
Code of Ethics Attachment B - Annual Acknowledgement	02/18/2010
Code of Ethics Attachment C - Complaint	02/18/2010
Comp Time Chart 2012	01/04/2012
Comp Time Chart 2013	12/18/2012
Criminal Background Check Consent	08/19/2009
Criminal Background Check Consent for Current Employees	08/19/2009
DFA Application	08/27/2009
Direct Deposit Hardship Exemption Request	10/20/2011
Disclosure of Employment of Family Members	07/17/2012
Drugfree Workplace	08/26/2009
Emergency Hire Request	05/15/2013
Employee Master Data	09/04/2012
Employment History and Emergency Contact	08/26/2009
Employment History and Emergency Contact Instructions	08/26/2009
Exceptionally Well Qualified Checklist	07/16/2010
FMLA - Certification of Qualifying Exigency for Military Family Leave	05/31/2012
FMLA - Certification or Serious Injury or Illness of Covered Military Family Leave	08/24/2011
FMLA - Designation Notice	05/08/2012
FMLA - Healthcare Provider for Employee Serious Health Condition	05/08/2012
FMLA - Healthcare Provider for Family Member Serious Health Condition	05/31/2012
FMLA - Leave Request	08/24/2011
FMLA - Notice of Eligibility and Rights and Responsibilities	05/17/2012
Form 1A-1 - First Report of Injury	09/28/2010
Form AR-N - Employee's Notice of Injury	01/12/2010
Form AR-S - Supplemental Report	01/12/2010
Form PECD1 - Employee's Report of Accident	01/12/2010
Form PECD2 - Worker's Comp Information Sheet	01/12/2010
Hiring Freeze Exception Request	06/22/2012
HR Response To Criminal Background Check for Applicants	08/19/2009
HR Response to Criminal Background Check for Current Employees	08/19/2009
I9 - Employment Eligibility and Verification	06/02/2010
Information Technology User Consent Agreement	09/20/2010
Internal Advertising Approval Request	02/13/2012
JVRR	02/27/2012
KASS	08/20/2009
Leave Balance Quota Correction	08/24/2011
Leave Balances for Transferring Employees	12/16/2009
Leave Calendar 2012	12/16/2011
Leave Calendar 2013	01/04/2013
Leave Payout Authorization	08/24/2011
Leave Reconciliation Checklist	08/27/2009
Leave Request	09/09/2009
Leave Request Instructions	08/26/2009
Mandatory Direct Depost Notification	08/24/2011
Mileage Reimbursement for (Medical Mileage)	01/12/2010
Movement of Current Employees to Approved Special Entry Rates	04/11/2012
New Hire Document Checklist	06/14/2012
New Labor Market Rates	08/27/2009
Notice Of Disciplinary Action	08/20/2009
Performance Evaluation Form - Employee	09/19/2011
Performance Evaluation Form - Senior Management	10/10/2011
Performance Evaluation Form \| Executive Director/Deputy Director	08/24/2011
Position Crossgrade Downgrade	12/14/2011
Proof of Prior Service	01/03/2012
Reasonable Accommodation	08/19/2009
Request to Stop Miscellaneous Deductions	08/20/2009
Selective Service	08/26/2009
Separation Memo	08/26/2009
Sick Leave Incentive Program Notice	08/26/2009
Special Entry Rate – Exceptionally Well Qualified Applicant	02/18/2013
Special Entry Rate Applicant Summary Sheet - Applicant Not Hired	05/09/2012
Special Entry Rate Applicant Summary Sheet - Applicant Not Hired Instructions	08/30/2011
Special Entry Rate Request – Labor Market Conditions	01/18/2013
State Employee ID Voucher	07/05/2012
Step 1 - Grievance Form	10/26/2011
Step 1 - Immediate Supervisor Reply to Employee	10/26/2011
Step 2 - Assistant Director Reply to Employee	10/26/2011
Step 3 - Department Director Reply to Employee	10/26/2011
Tax Obligation Policy Receipt	09/03/2010
Timesheet	09/09/2011
Timesheet Instructions	08/26/2009
TR-1	08/26/2009
Travel Authorization	08/26/2009
VSP-1	06/06/2011
VSP-2	08/26/2009
W4	05/02/2013
Worker's Compensation Memo	01/12/2010