The Official Website of the State of Arkansas

Forms

Forms

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ADA

TitleDate Posted
ADA Employee Request Form06/20/2019
ADA Medical Questionnaire10/26/2022

Criminal Background Check

TitleDate Posted
Criminal Background Check Consent09/20/2022

Discipline

TitleDate Posted
Notice of Disciplinary Action 05/31/2024
Disciplinary Action Violation Templates

Discrimination/Harassment

TitleDate Posted
DFA Discrimination and Sexual Harassment Complaint10/26/2022

Ethics and Fraud

TitleDate Posted
Code of Ethics Attachment A10/16/2018
Code of Ethics and Anti-Fraud Policy10/16/2018
Code of Ethics Attachment B – Annual Acknowledgement10/16/2018
Code of Ethics Attachment C – Complaint10/16/2018

FMLA

TitleDate Posted
Employee Rights and Responsibilities Poster11/02/2020
Family Medical Leave Request02/17/2021
Healthcare Provider for Employee Serious Health Condition03/21/2024
Healthcare Provider for Family Member Serious Health Condition03/21/2024
Notice of Eligibility and Rights and Responsibilities03/21/2024
Designation Notice03/21/2024
Certification of Qualifying Exigency for Military Family Leave03/21/2024
Serious Injury or Illness of a Current Servicemember – for Military Family Leave03/21/2024
Serious Injury or Illness of a Veteran for Military Caregiver Leave03/21/2024

Grievance

TitleDate Posted
Dispute Resolution Form10/16/2018

Payroll/Time/Leave

TitleDate Posted
Display Absence Quota Instructions10/16/2018
Address Change10/28/2022
Bank Details – Direct Deposit10/16/2018
Direct Deposit Hardship Exemption Request05/19/2021
Leave Balance Quota Correction09/30/2021
Leave Balances for Transferring Employees10/28/2022
Leave Payout Authorization09/30/2021
Quota Overview Instructions10/16/2018
Sick Leave Incentive Program Notice10/16/2018
Supervisory Leave10/16/2018
Requested for Approved Leave Without Pay08/14/2023
Request to Stop Miscellaneous Deductions10/28/2022

Personnel/Hiring

TitleDate Posted
DFA Performance Evaluation Appeal Form06/13/2024
Employee Disclosure/Certification and Employment of Family Members Forms10/04/2023
Emergency Hire Request10/16/2018
Employee Master Data08/09/2019
Financial Obligation Policy Receipt07/22/2019
Hiring Freeze Exception Request07/28/2023
I9 – Employment Eligibility and Verification08/07/2023
I9 – Employment Eligibility and Verification Instructions01/08/2021
Internal Advertising Approval Request10/16/2018
JVR12/03/2020
Mandatory Direct Deposit Notification10/16/2018
New Hire Document Checklist09/12/2024
Position Crossgrade Downgrade09/22/2020
Proof of Prior Service04/07/2022
Reference Consent and Release09/15/2022
State Employee ID Voucher10/16/2018

Remote Work

TitleDate Posted
DFA Remote Work Agreement07/05/2023
Job Aid – Alternative Work Site Requirements (IRS Pub. 1075)07/05/2023

Special Entry Rates

TitleDate Posted
Exceptionally Well Qualified – Special Entry Rate10/16/2018
Movement of Current Employees to Approved Special Entry Rates10/16/2018
New Labor Market Rates10/16/2018
Labor Market Conditions10/16/2018

Termination

TitleDate Posted
Change In Employment Status04/20/2021
Separation Memo10/27/2022

Travel

TitleDate Posted
TR-110/16/2018
Travel Authorization04/24/2023

Vehicle Safety

TitleDate Posted
TitlePosted
VSP-101/10/2023

Workers Comp

TitleDate Posted
Workers’ Compensation Incident Report10/16/2018
DFA Alcoholic Beverage Control Company Nurse Poster09/23/2024
DFA Arkansas Lottery Company Nurse Poster09/23/2024
DFA Assessment Coordination Company Nurse Poster09/23/2024
DFA Child Support Enforcement Company Nurse Poster09/23/2024
DFA Driver Services Company Nurse Poster09/23/2024
DFA Medical Marijuana Comm Company Nurse Poster09/23/2024
DFA Motor Vehicle Company Nurse Poster09/23/2024
DFA Revenue Services Company Nurse Poster09/23/2024
DFA Racing Commission Company Nurse Poster09/23/2024
DFA Company Nurse Poster09/23/2024
Workers’ Compensation Procedures09/23/2024