Forms

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Benefits Forms
1)	Carrier Change Form
2)	Change of Name/Address Notification
3)	College Release Program and Staff Education Reimbursement Request
4)	Family Medical Leave/Parental Leave Request
5)	FMLA Authorization for the release of medical information
6)	FMLA Certification of Health Care Provider for Employee
7)	FMLA Certification of Health Care Provider for Family Member
8)	FMLA Certification of Qualifying Exigency for Military Family Leave
9)	FMLA Certification for Serious Injury of Covered Servicemember - Caregiver Leave
10)	Fitness Release Time Application
11)	Optional Retirement Plan Termination Notice
12)	Optional Retirement Program Certification
13)	Salary Reduction Agreement (ORP & TDA)
14)	Sick Leave Pool Contribution/Withdrawal Request
15)	The Edge (Staff Council Form)

Claim Forms
1)	Minnesota Accelerated Life Claim Form
2)	Fort Dearborn Disability Claim Form
3)	Minnesota Life Dismemberment Claim Form
4)	Minnesota Extended Life Claim Form
5)	Health Select Claim Form
6)	Pay Flex Claim Form

Workers' Compensation Forms
1)	Authorization for Release of Information (SORM-16)
2)	Employee's Election Regarding Utilization of Sick and Annual Leave (SORM-80)
3)	Employee's Report of Injury (SORM-29)
4)	Witness Statement (SORM-74)
5)	Supervisor Report of Accident

EEO Forms
1)	Veterans Status Questionnaire

Employment Forms
1)	Consulting and Paid Professional Service Application Form (for faculty and staff working a second job)
2)	Voluntary Modification of Employment Agreement
3)	Emergency Evacuation Assistance Form
3)	Employee Data Sheet
4)	Employment Authorization Request
5)	Fair Credit Reporting Act
6)	Internal Employment Request Form
7)	Interview Request for Faculty Candidate
8)	Interview Request for Professional Staff Candidate
9)	Job Offer Request Form
10)	Motor Vehicle Record Evaluation Request
11)	New Employee Orientation Survey
12)	Notice of Terms of Initial Appointment
13)	Personnel Recommendation
14)	Position Announcement
15)	Required Documents for New Employees
16)	Security Sensitive Position Questionnaire
17)	Student Assistant Job Announcement Form
18)	Student Worker Statement of FERPA Understanding

Payroll Forms
1)	Advance Authorization for Overtime
2)	Application for Leave
3)	Direct Deposit Authorization
4)	Moving and Relocation Expense Form
5)	Pay Option Form
6)	Time and Effort Adjustment Request
7)	Timesheet - Biweekly
8)	W4

Compensation/Performance Management Forms
1)	eAppraisal End-User Manual
2)	Job Analysis Questionnaire (JAQ)

Progressive Disciplinary Forms
1)	Notice of Verbal Counseling

Prior approval from ESO is required for forms # 2 through # 5
2)	Employee Written Reprimand
3)	Notice of Suspension Without Pay
4)	Notice of Dismissal from Employment
5)	Performance Improvement Plan (PIP)

General Forms
1)	Communication Stipend Request
2)	Business Use Only Verification
3)	HRMS PeopleSoft Operator ID Request
4)	Media Release Form
5)	Statement of Non-Compliance

Separation/Exit Forms

Separation-Clearance Form

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Last updated or reviewed on 2/8/13