Refer to Classified Transactions for instructions on personnel transactions. Refer to the summary of benefits for staff for additional information on benefits entitlements.
| FORMS by Name | Dated | Instructions or Information |
Versions | |||
|---|---|---|---|---|---|---|
| Above Step Request (PER-3) | 8/2011 | PPM 4450.30 | RTF | Word | ||
| Accident/Injury Report (PER-17) (Workers' Compensation) | 02/2010 | PPM 4820.100 | RTF | Word | ||
| Administrative Leave Reporting | 6/2003 | PPM 4860 | RTF | Word | ||
| Advance Leave Agreement PER-60 | 10/2009 | Leave Advancement Policy | RTF | Word | ||
| Affirmative Action Classified Selection Report (PER-10) | Affirmative Action-Recruitment | RTF | Word | |||
| Agency Payroll Deduction Authorization | 5/2007 | Agency Payroll Deductions | RTF | Word | ||
| Agreement of Understanding for Overlapping Appointment (PER-28) | 10/2004 | Military Service Policy | RTF | Word | ||
| Agreement for Limited Term Appointment (PER-43) | 10/2004 | PPM 4460.40 | RTF | Word | ||
| Agreement for Reimbursement of Moving Expenses(DA-22) | 11/1998 | Moving Expenses | RTF | Word | ||
| Agreement for School Employee Appointment (PER-21) | 3/2004 | RTF | Word | |||
| Annual Review of Classified Position Descriptions (PER-26) | 07/2008 | PPM 4210 | RTF | Word | ||
| (Summer) Application for Tuition Assistance (2013) | 2013 | |||||
| Application for Tuition Assistance | 2013/2014 | |||||
| Application for Tuition Assistance - Dependents/Spouses | 2013/2014 | Dependent/spouse grant | ||||
| Appointment Form (PER-38) | 03/2011 | Unclassified Classified |
RTF | Word | ||
| Authorization to Release Information | 10/2004 | PPM 4010 | RTF | Word | ||
| Background Check Request Form (PER-59) | 01/2013 | Background Checks Background Check Form Instructions |
||||
| Beneficiary Designation (KPERS-7/99) | 07/2006 | PPM 4820.60 | ||||
| Change or Separation Form (PER-39) | 12/2006 | Unclassified Classified Grad Student |
RTF | Word | ||
| K-State Classified Award of Excellence Nomination Form | Guidelines | RTF | Word | |||
| Departmental Employee of the Year Award & Recognition Program Monetary Award Payment Form (PER-7) | 11/2009 | Guidelines | RTF | Word | ||
| Designation of Beneficiary (KPERS-7/99) | 07/2006 | PPM 4820.60 | ||||
| Direct Deposit of Employee Pay (PER-58) | 12/2010 | Instructions Information |
RTF | Word | ||
| Educational Authorization Form (PER-25) | 5/1998 | PPM 4870.20 | RTF | Word | ||
| Employee Conference Form | PPM 4020 | |||||
| Employee Separation Checklist (PER-24) | 06/2011 | Classified Separations Unclassified Separations PPM 4950 |
RTF | Word | ||
| Employment Application (Online) | Classified Employment | |||||
| Employment Eligibility Verification (I-9) | 03/2013 | Included | ||||
| Exit Interview for Classified Employees (PER-16) | 6/2003 | PPM 4950 | RTF | Word | ||
| Flexible Spending Claim Form | 2011 | Flexible Spending Accounts | ||||
| Flexible Spending Account Direct Deposit/E-Mail Notification Form | Flexible Spending Accounts | Word | ||||
| Flexible Spending Account Enrollment/Change Form | 2011 | Flexible Spending Accounts | ||||
| FMLA Certification of Health Care Provider for Employee's Serious Health Condition | FMLA Dept. of Labor | |||||
| FMLA Certification of Health Care Provider for Family Member's Serious Health Condition | FMLA Dept. of Labor | |||||
| FMLA Notice of Eligibility and Rights & Responsibilities | FMLA Dept. of Labor | |||||
| FMLA Designation Notice | FMLA Dept. of Labor | |||||
| FMLA Certification of Qualifying Exigency For Military Family Leave | FMLA Dept. of Labor | |||||
| FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave | FMLA Dept. of Labor | |||||
| KSU Foreign National Tax Information Form (PER-15) | 07/2007 | Visa Classifications | RTF | Word | ||
| Health Care Selection Form | Health Insurance | |||||
| Health Insurance Affidavit of Common Law Marriage | 2013 | Health Insurance | ||||
| Health Insurance Application for Coverage of Handicapped Dependent Child | 2013 | Health Insurance | ||||
| Health Insurance Change Form | 2013 | Health Insurance | ||||
| Health Insurance Communication Form | 2013 | Health Insurance | ||||
| Health Insurance Dependent Grandchild Affidavit | 2013 | Health Insurance | ||||
| Health Insurance Enrollment Form | 2013 | Health Insurance | ||||
| HIPAA- Authorization Form for Release of Medical Information | 2013 | Health Insurance | ||||
| Health Savings Account Enrollment & Change Form | 2013 | Health Insurance | ||||
| HealthyKIDS Application | Information | Online | ||||
| Holiday Emergency Overtime Reporting | 6/2003 | PPM 4450.70 | RTF | Word | ||
| HRIS/PeopleSoft Access Form | Instructions (pdf) HRIS Roles |
RTF | Word | |||
| NEW Online HRIS Access Termination Form | Online | |||||
| Initial Screening of Candidates Prior to Interview (AA-28) | Instructions | RTF | Word | Excel | ||
| Intellectual Property Agreement | Information | RTF | Word | |||
| Investment Agreement - Voluntary Pre-Tax Retirement Plan (PER-19) | 06/2012 | PPM 4810.80 | ||||
| Investment Agreement - Voluntary Roth After-Tax Retirement Plan (PER-19R) | 06/2012 | PPM 4810.80 | ||||
| Kansas Employee's Withholding Allowance Certificate (K-4) | 09/2007 | Information | ||||
| Learning Quest Direct Deposit Change or Enrollment Form | Information | |||||
| Leave Balance Correction Sheet (PER-9) | 5/2001 | Information | RTF | Word | ||
| Leave Record | 05/2013 for FY 2014 |
Instructions | RTF | Word | Excel | |
| Leave Record | 05/2012 for FY 2013 |
Instructions | RTF | Word | Excel | |
| Leave Request-Hourly (Non-Exempt) Employees | Instructions | Online | ||||
| Leave Request-Salaried (Exempt) Faculty and Staff | Instructions | Online | ||||
| 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 Course Data Sheet | 12/2008 | Instructions (PDF) | RTF | Word | ||
| New Employee Orientation Forms Checklist | 11/2001 | PPM 4070 | RTF | Word | ||
| Non-Resident Alien Forms | Non-Resident Alien Employment | |||||
| Notification of Retirement (PER-37) | 6/2009 | PPM 4810 | RTF | Word | ||
| Optional Group Life Enrollment Form | Optional Life | |||||
| Optional Group Life Reduction/Cancellation Form | 09/2003 | Optional Life | ||||
| Orientation Checklist | 08/2012 | PPM 4070 | RTF | Word | ||
| Orientation Forms Checklist | 11/2001 | PPM 4070 | RTF | Word | ||
| Overtime Compensation Agreement for Non-Exempt Employees (PER-34) | 02/2007 | PPM 4220.70 | RTF | Word | ||
| Paycheck Stop Payment Request (DA-6P) | 05/2006 | Information | Excel | |||
| Payroll Transfer Form (PER-44) | 04/2009 | Instructions | Excel | |||
| Performance Management Process Form | NEW | Performance
Management Process Instructions |
RTF | Word | ||
| Position Data Sheet (PER-36) | 11/2012 | Unclassified Classified |
RTF | Word | ||
| Position Description (Classified) (DA 281-2 Special) | 1/1999 | PPM 4210 Position Descriptions Checklist |
RTF | Word | ||
| Prescription Claim Form | Prescription Drug Program | |||||
| Request for Certified Names (PER-5) | 11/2012 | Instructions Department Recruitment Procedures |
||||
| Retirement Notification (PER-37) | 6/2009 | PPM 4810 | RTF | Word | ||
| Shared Leave Donation Form (PER-64D) | 4/2012 | Instructions | RTF | Word | ||
| Shared Leave Request Form (PER-64A&B) | 3/2013 | Instructions | RTF | Word | ||
| Substance Abuse Policy Affirmation Form | 5/2007 | Information | RTF | Word | ||
| Tax Clearance Information Form for Candidates and New Hires (DA-2004a) | 05/2004 | Information | ||||
| 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 | |||||
| (Summer) Tuition Assistance Application (2013) | 2013 | |||||
| Tuition Assistance Application | 2013/2014 | |||||
| Tuition Assistance Application - Dependents/Spouses | 2013/2014 | Dependent/spouse grant | ||||
| Workers' Compensation Accident/Injury Report (PER-17) | 02/2010 | PPM 4820.100 | RTF | Word | ||
| Workers' Compensation Mileage Reimbursement Form | Information | RTF | Word | |||
| W-4 Employee's Withholding Allowance Certificate OR Update online in Employee Self Service |
2013 | Included Information |
||||
| Withholding form Kansas Employee's Withholding Allowance Certificate (K-4) |
09/2007 | Information | ||||
| W-9 Request for Taxpayer Identification Number and Certification | 12/2011 | Included | ||||