Forms

Forms

NOTICE:
Some internet browsers have a built in PDF viewer that may not be compatible with our forms. Adobe Reader may be required for your browser or you may need to download the form to complete it properly.

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
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 ABC Enforcement Company Nurse Poster 09/23/2024
DFA AR Tobacco Control Board 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