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Kansas State University

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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

Division of Human Resources
Kansas State University
103 Edwards Hall
Manhattan, KS 66506-4801
785-532-6277
785-532-6095 (fax)
8 a.m. - 5 p.m. (CST)
Contact HR

Leave Forms

The various leaves are covered in the Leave Programs pages. Information for reporting leave is furnished on the Leave Reporting page.

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Alphabetical List of Leave Forms
FORMS by NameDatedInstructions
or Information
Versions
Administrative Leave Reporting 6/2003 PPM 4860 RTF Word PDF 
Advance Leave Agreement PER-60 10/2009 Leave Advancement Policy RTF Word PDF  
FMLA Certification of Health Care Provider for Employee's Serious Health Condition   FMLA Dept. of Labor     PDF 
FMLA Certification of Health Care Provider for Family Member's Serious Health Condition   FMLA Dept. of Labor     PDF 
FMLA Notice of Eligibility and Rights & Responsibilities   FMLA Dept. of Labor     PDF 
FMLA Designation Notice   FMLA Dept. of Labor     PDF 
FMLA Certification of Qualifying Exigency For Military Family Leave   FMLA Dept. of Labor     PDF 
FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave   FMLA Dept. of Labor     PDF 
Holiday Emergency Overtime Reporting 6/2003 PPM 4450.70 RTF Word PDF 
Leave Balance Correction Sheet (PER-9) 10/2013 Information RTF Word PDF 
Leave Record 05/2013
for FY 2014
Instructions RTF Word PDF Excel
Leave Record 03/2014
for FY 2015
Instructions RTF Word PDF Excel
Leave Request-Hourly (Non-Exempt) Employees   Instructions      Online
Leave Request-Salaried (Exempt) Faculty and Staff   Instructions      Online
Leave-Sabbatical Leave Application Form   Guidelines     PDF Online
Shared Leave Donation Form (PER-64D) 4/2012 Instructions RTF Word PDF  
Shared Leave Request Form (PER-64A&B) 3/2013 Instructions RTF Word PDF