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Form directions and/or additional information are provided in the Instructions or Information Column or within the form.
Technical
Support for
Forms:
Kathy Kugle
(785) 532-1885
or
email
kkugle@ksu.edu
| FORMS by Name | Dated | Instructions or Information |
Versions | |||
|---|---|---|---|---|---|---|
| Accident/Injury Report (PER-17) (Workers' Compensation) | 02/2007 | PPM 4820.100 | RTF | Word | ||
| Application for President's Scholarship (PER-32A) | 01/2007 | PPM 4870.40 | RTF | Word | ||
| Application for Tuition Assistance (PER-32) | 05/2007 | PPM 4870.30 | RTF | Word | ||
| Beneficiary Designation (KPERS-7/99) | 07/2006 | PPM 4820.60 | ||||
| Delta Dental Claim Form | 06/2002 | Dental Insurance | ||||
| Designation of Beneficiary (KPERS-7/99) | 07/2006 | PPM 4820.60 | ||||
| Documentation of Service for Immediate Participation in Regents Retirement Program (PER-33) | 01/2007 | PPM 4810.20 | RTF | Word | ||
| Educational Authorization Form (PER-25) | 5/1998 | PPM 4870.20 | RTF | Word | ||
| Family and Medical Leave Act (FMLA) Certification of Health Care Provider | Classified PPM 4860.50 Unclassified PPM 4865.60 |
RTF | Word | |||
| Family and Medical Leave Act (FMLA) Employee Request Form | 01/2007 | Classified PPM
4860.50 Unclassified PPM 4865.60 | RTF | Word | ||
| Family and Medical Leave Act (FMLA) Employer Checklist | 01/2007 | Classified PPM
4860.50 Unclassified PPM 4865.60 |
RTF | Word | ||
| Family and Medical Leave Act (FMLA) Notice of Designation of FMLA Leave | 01/2007 | Classified PPM
4860.50 Unclassified PPM 4865.60 |
RTF | Word | ||
| Family and Medical Leave Act (FMLA) Notice to Employees Requesting FMLA | 5/1999 | Classified PPM
4860.50 Unclassified PPM 4865.60 |
RTF | Word | ||
| Graduate Research Assistant/Teaching Assistant Health Insurance | 2007/2008 | Information | ||||
| Health Insurance Affidavit of Common Law Marriage and Request for Enrollment of Common Law Spouse | 04/2005 | Health Insurance | RTF | Word | ||
| Health Insurance Application for Coverage of Handicapped Dependent Child | 02/2004 | Health Insurance | RTF | Word | ||
| Health Insurance Claim Form (State of Kansas) | 1/1998 | Health Insurance | ||||
| Health Insurance Communication Form | 3/2003 | Health Insurance | RTF | Word | ||
| Investment Agreement - Mandatory Retirement Plan (Kansas Board of Regents) (PER-13) | 01/2007 | PPM 4810.20 | RTF | Word | ||
| Investment Agreement - Voluntary Retirement Plan (Kansas Board of Regents) (PER-19) | 01/2007 | PPM 4810.80 | RTF | Word | ||
| KanElect Claim Form | 1/2004 | Flexible Spending Accounts | Word | |||
| KanElect Direct Deposit/E-Mail Notification Form | Flexible Spending Accounts | Word | ||||
| Kansas Board of Regents Mandatory Retirement Plan Investment Agreement (PER-13) | 01/2007 | PPM 4810.20 | RTF | Word | ||
| Kansas Board of Regents Voluntary Retirement Plan Investment Agreement (PER-19) | 01/2007 | PPM 4810.80 | RTF | Word | ||
| Learning Quest Direct Investment Form | Information | |||||
| Learning Quest Payroll Deduction Change Form | Information | |||||
| Life Insurance Beneficiary Designation Form (TEA) | 07/2001 | Included TEA Life Insurance |
||||
| Life Insurance Enrollment Form (TEA) | TEA Life Insurance | |||||
| Life Insurance Request to Change or Cancel Insurance Policy Form (TEA) | TEA Life Insurance | |||||
| Life Insurance Statement of Health (TEA) | TEA Life Insurance | |||||
| Mileage Reimbursement Form (Workers' Compensation) | Information | RTF | Word | |||
| New Employee Orientation Forms Checklist | 11/2001 | PPM 4070 | RTF | Word | ||
| Notification of Retirement (PER-37) | 1/2002 | PPM 4810 | RTF | Word | ||
| Orientation Checklist | 12/2007 | PPM 4070 | RTF | Word | ||
| Orientation Forms Checklist | 11/2001 | PPM 4070 | RTF | Word | ||
| Prescription Claim Form | Prescription Drug Program | |||||
| Prescription Drug Program Grievance Form | 2/1996 | Prescription Drug Program | RTF | Word | ||
| President's Scholarship Application (PER-32A) | 01/2007 | PPM 4870.40 | RTF | Word | ||
| Retirement Notification (PER-37) | 1/2002 | PPM 4810 | RTF | Word | ||
| Retirement Plan Investment Agreement - Mandatory (Kansas Board of Regents) (PER-13) | 01/2007 | PPM 4810.20 | RTF | Word | ||
| Retirement Plan Investment Agreement - Voluntary (Kansas Board of Regents) (PER-19) | 01/2007 | PPM 4810.80 | RTF | Word | ||
| Savings Bond Payroll Savings Authorization (PER-14) | 01/2007 | U.S. Savings Bonds | RTF | Word | ||
| Shared Leave Donation Form | 8/2001 | Classified PPM
4860.140 Unclassified PPM 4865.140 | RTF | Word | ||
| Shared Leave Request Form | 10/2007 | Classified PPM
4860.140 Unclassified PPM 4865.140 |
RTF | Word | ||
| TEA Life Beneficiary Designation Form | 07/2001 | Included TEA Life Insurance |
||||
| TEA Life Insurance Enrollment Form | TEA Life Insurance | |||||
| TEA Life Insurance Request to Change or Cancel Insurance Policy Form | TEA Life Insurance | |||||
| TEA Life Insurance Statement of Health | TEA Life Insurance | |||||
| Tuition Assistance Application (PER-32) | 05/2007 | PPM 4870.30 | RTF | Word | ||
| U.S. Savings Bond Payroll Savings Authorization (PER-14) | 01/2007 | U.S. Savings Bond | RTF | Word | ||
| Workers' Compensation Accident/Injury Report (PER-17) | 02/2007 | PPM 4820.100 | RTF | Word | ||
| Workers' Compensation Mileage Reimbursement Form | Information | RTF | Word | |||
