51AV

Documents & Forms

Americans with Disabilities Act (ADA) Accommodation Request

• Accommodation Request Assessment Medical Certification of Physician or Practitioner
• Release of Medical Information

Background Check Authorization

(Disclosure, Acknowledgement and Authorization, and Summary of Your Rights under Fair Credit Reporting Act)

Disclosure, Acknowledgement, Application Authorization Form, and Summary FCRA

Benefit Enrollment

• Guardian Enrollment Change Form
• Health Equity Wage Works Enrollment Form

Beneficiary Update Form

• Retirement System of 51AV 
• Guardian
• AFLAC

Complaints

• University Complaint Form (To file a general complaint or concern.)
• Complaint Form (To file a complaint of discrimination, harassment, and/or retaliation)

Online Forms

• EPAF Banner Access Request

Employment Visa Request

Employment Visa Request Form

Family and Medical Leave Act Forms (FMLA) and Information

• FMLA Employee Leave Request Form
• FMLA Physician's Certification Form for Employee Serious Health Condition
• FMLA Physician's Certification Form for Family Members Serious Health Condition
• Employee Guide to the Family and Medical Leave Act from Dept of Labor

Grievance

• Faculty Grievance Form
• Staff Grievance Form

Leave Request (includes compensatory leave)

Name and Social Security Change

• Name Change Procedure and Checklist
• Demographic Change (SSN Change)

Outside Employment Verification

Outside Employment Verification

Payroll Forms

Standard Forms for All Employees (Submission Instructions Below)

• Employee Profile Data Form
• A-4 51AV Withholding Allowance Certificate (State)
• I-9 Employment Eligibility Verification
• Banner Self-Service Direct Deposit User Guide
• Payroll Deduction Authorization

Submission Instructions for the Payroll Forms

• Graduate Assistant/Part-time/Adjunct Personnel Employment - For initial hire, submit directly to the Office of Human Resources
• Bi-weekly Personnel Employment - Submit the above "Standard Forms" to the Office of Human Resources
• Full-Time Faculty & Staff - Forms are submitted via WorkBright Onboarding System

Submission Instructions for Online Consent W-2 form

• Online Consent W-2 Form

 

Performance Evaluations

Evaluations for Staff and Non-Academic Administrative-Supervisory

• Staff Performance Evaluation
• Non-Academic Admin Supervisory Performance Evaluation
• Leadership Performance Evaluation (President's Cabinet)
• Staff Assessment Form (Word Document)
• Performance Improvement Plan (PIP)

Evaluations for Faculty and Academic Administrators

(These forms are managed by the Office of Academic Affairs. The forms must be submitted directly to the Office of Academic Affairs, Patton Hall 108.)

• Administrative Staff Performance Evaluation
• Faculty Evaluation Form

Reduction Authorization Forms for 403b or 457 Plans (Full-Time Faculty and Staff)

• RSA-1 Enrollment Packet
• Salary Reduction Agreement (Multiple Plans)(403b or 457b) (Submit form to H.R. Office.)

Reporting Workplace Injury or Illness Incident

• Workplace Injury or Illness Incident Report
• Workplace Medical Practitioner's Statement
• BOA On The Job Injury Claim Instructions and Form

Requests for Employee Information

• Request for Employment Verification
• Request for Information from an Employee's File
• Personnel and Benefits File Access and Copy Request

Salary and Wage Administration

• Overtime Compensation Form
• Overtime Compensation for Non-Exempt Employees-Compensatory Leave Hours
• Straight Time Compensation Form
• Timekeeping/Hours Record for Non-Exempt Employees
• Escrow Authorization

Tuition Assistance

Tuition Assistance