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Before downloading any documents, please read about the document formats. Click on the format icon to download the document.
Go Directly To:| Benefits Forms |  back to top |
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| 04/13 | Dependent Information Update Form | MS Word | |||
| X | 10/10 | Child of Opposite Sex Domestic Partner Declaration of Tax Status Form | |||
| 08/08 | Child of Same Sex Domestic Partner Declaration of Tax Status Form | ||||
| X | 12/10 | Domestic Partner Change Form | MS Word | ||
| X | 10/12 | HSA Voluntary Contribution Designation Form | MS Word | ||
| X | 10/12 | Flexible Spending Account Election Change Form | MS Word | ||
| X | 02/13 | Qualified Life Event Form | MS Word | ||
| X | 10/10 | Qualified Opposite Sex Domestic Partner Affidavit | |||
| 08/08 | Qualified Same Sex Domestic Partner Affidavit | ||||
| 02/13 | Flexible Spending Account Claim Form - ASI | Yes | |||
| 02/13 | Flexible Spending Account Direct Deposit Sign Up Form | Yes | |||
| Benefits - Life Insurance Forms | back to top |
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| 7/00 | ReliaStar Life Insurance - Enrollment Form | ||||
| 8/04 | ReliaStar Life Insurance - Request for Change Form | ||||
| Child Care Forms | back to top |
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| X | Employee Child Care Voucher Program Application | See LWC website | |||
| X | Employee Child Care Voucher Program Provider Verification Form | See LWC website | |||
| X | Sick Child and Emergency/Back-Up Care Program for Employees | See LWC website | |||
| X | Sick Child and Emergency/Back-Up Care Program for Students | See LWC website | |||
| Coaching and Discipline | back to top |
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| X | 10/05 | Discharge Memo Format (For Regular Classified Staff) | HTML / MS Word | Yes | |
| X | 10/05 | Disciplinary Probation Memo Format (For Regular Classified Staff) | HTML / MS Word | Yes | |
| X | 10/05 | Disciplinary Suspension Memo Format (For Regular Classified Staff) | HTML / MS Word | Yes | |
| X | 05/08 | Initial Probation Termination Memo Format (For Classified Staff on Initial Six-Month Probation Period) | NEW TEMPLATE HERE | Yes | |
| X | 1/07 | Investigative Leave with Pay Memo Format | HTML / MS Word | Yes | |
| X | 9/04 | Job Abandonment Letter Format | HTML / MS Word | ||
| X | 10/05 | Pre-discharge or Pre-suspension Meeting Memo Format (For Regular Classified Staff) | HTML / MS Word | Yes | |
| X | 09/09 | Promotion/Transfer Probationary Period Performance Improvement Memo Format (For Classified Staff on a Promotion/Transfer Probationary Period) | NEW FORM HERE | Yes | |
| X | 09/09 | Promotion/Transfer Probationary Period Termination Notice Format (For Classified Staff on a Promotion/Transfer Probationary Period) | NEW FORM HERE | Yes | |
| X | 10/05 | Written Warning Memo Format (For Regular Classified Staff) | HTML / MS Word | Yes | |
| Compensation Forms | back to top |
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| X | 8/98 | Position Description Format | Link | ||
| X | 9/00 | Request for In-Classification Career Progression Form | MS Word | Yes | |
| 7/12/01 | Supplemental Compensation Form-Appointed Personnel | Yes | |||
| 7/12/01 | Supplemental Compensation Form-Classified Staff | Yes | |||
| 7/12/01 | Supplemental Compensation Form-Graduate Assistants/Associates | Yes | |||
| Designated Campus Colleagues (DCC) | back to top |
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| X | 11/12 | Affiliate Verification Form | MS Word | ||
| X | 01/13 | Designated Campus Colleague Worksheet | MS Word | ||
| Leave of Absence Forms | back to top |
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| X | 02/13 | Compassionate Transfer of Leave Contribution Form | Yes | ||
| X | 10/12 | Compassionate Transfer of Leave Request Form | Yes | ||
| X | 04/11 | Employer Response to Employee Regarding Family and Medical Leave | MS Word | ||
| X | 9/09 | Extended Leave of Absence Form - Classified Staff | MS Word | Yes | |
| X | 04/11 | Family and Medical Leave Request Form | MS Word | Yes | |
| X | 04/11 | FML Certification of Health Care Provider | MS Word | Yes | |
| X | 8/05 | Leave Of Absence Unpaid - Appointed Personnel: Template For Department Head Approval/Denial of Employee Request | HTML / MS Word | ||
| X | 8/05 | Leave Of Absence Unpaid - Appointed Personnel: Template For Department Request to the Provost | HTML / MS Word | ||
| X | 8/05 | Leave Of Absence Unpaid - Appointed Personnel: Template For Employee Request to Department Head | HTML / MS Word | ||
| Misc. Forms | back to top |
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| X | 11/01 3/07 |
Extended Temporary Employment Staff Memorandum of Understanding | This form is no longer in use effective January 2007. Use the online Offer Letter builder for issuing an offer letter for an Extended Temporary Employment (ETE) new hire. | ||
| 4/07 | Notice of Appointment for Graduate Assistants and Associates | ||||
| Request for Revision or Addition to UHAP | MS Word | Yes | |||
| X | 07/09 | Request for Time In Position Waiver | MS Word | Yes | |
| New Employee Packet Forms | back to top |
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| X | 9/07 | New Employee Packet | Currently being revised. Please use documents below. | ||
| The individual forms listed below are also contained in the New Employee Packet. | |||||
| X | 3/07 | Benefits and Retirement Agreement | This form is no longer in use effective January 2007. The online Offer Letters include the benefits and retirement terms for all employment types. | ||
| X | 5/02 | Employment Eligibility Verification (Form I-9) | Link | Yes | |
| X | 3/07 | New Hire Information | MS Word | ||
| X | 3/07 | Notification of Policies | MS Word | ||
| X | 9/11 | Options During 90-Day Waiting Period for Healthcare | MS Word | ||
| X | 11/10 | Person Information Form | MS Word | ||
| X | 8/10 | Race/Ethnicity/Sex Self-Identification Form | MS Word | ||
| X | 12/09 | State of Arizona Employee Loyalty Oath | MS Word | Yes | |
| X | 3/12 | Transition Allowance Declaration Form | MS Word | ||
| X | 3/07 | Veteran/Disability Self-Identification Form | MS Word | ||
| New Hire/Appointment Forms | back to top |
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| X | 8/10 | Hiring Form (Competitive and Non-Competitive) | MS Word | ||
| Offer Letters - College of Medicine /UPH | |||||
| X | 0/13 | University Physicians Healthcare Offer Letter (To be printed on UPH letterhead) | Link | ||
| Offer Letters - College of Medicine General | |||||
| X | 3/12 | College of Medicine Clinical Assistant Exception Pay Authorization Form | MS Word | No | |
| Offer Letters - College of Medicine Offer Letter Builders | back to top |
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| X | 02/10 | College of Medicine Clinical Faculty Offer Letter Builder (University Physicians Healthcare) | Link | Yes | |
| Offer Letter Builders - Classified Staff and Appointed Personnel | back to top |
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| X | 05/11 | Classified Staff Offer Letter Builder | Link | Yes | |
| X | 05/11 | Faculty and Appointed Personnel Offer Letter Builder | Link | Yes | |
| Important information regarding the hiring of development officers. | Yes | ||||
| X | 04/11 | Limited-term Faculty Service Offer Letter Builder | Link | Yes | |
| Performance Evaluation Forms | back to top |
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| 04/13 | 3 Point Feedback | MS Word | |||
| X | 08/12 | Performance Feedback for Individual Contributors | MS Word | ||
| X | 08/12 | Performance Feedback for Managers and Supervisors | MS Word | ||
| X | 08/12 | Performance Feedback / Five-Point Rating Format | MS Word | ||
| X | 1/98 | Factors and Standards Format / Performance Appraisal | MS Word | Yes | |
| X | 1/98 | Narrative Format / Performance Appraisal | MS Word | Yes | |
| X | 1/98 | Objectives, Factors and Standards Format / Performance Appraisal | MS Word | Yes | |
| X | 12/06 | Performance Feedback for Individual Contributors | MS Word | Yes | |
| X | 12/06 | Performance Feedback for Managers and Supervisors | MS Word | Yes | |
| X | 1/98 | Traditional Eight-factor Report of Performance Appraisal | MS Word | Yes | |
| Pre-Employment & Background Checking Forms | back to top |
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| 2/05 | Adverse Action Notice (Candidate) | MS Word | |||
| 2/05 | Adverse Action Notice (Employee) | MS Word | |||
| 3/08 | Candidate Consent and Disclosure Form | MS Word | |||
| 2/05 | Pre-Adverse Action Notice | MS Word | |||
| 8/06 | Request for Criminal Background/DMV Check (for Positions not Maintained in Career Track) | Online Form (requires NetID) |
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| 2/05 | Request for Security Sensitive Status | MS Word | |||
| 2/05 | Summary of Rights under FCRA | MS Word | |||
| 3/05 | UA CDL Release Form | MS Word | |||
| Qualified Tuition Reduction Forms | back to top |
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| X | 04/13 | Application for Qualified Tuition Reduction - Retirees and Employees on LTD only | MS Word | This form is for retirees and employees on Long Term Disability only. Active employees and UA affiliates should apply online in UAccess Employee. Click here for more information. | |
| X | 04/13 | Application for Domestic Partner Tuition Program - Retirees only | MS Word | This form is for retirees only. Active Employees should apply online in UAccess Employee. Click here for more information. | |
| Recruitment Forms | back to top |
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| X | 9/12 | Faculty Search Plan Worksheet | MS Word | ||
| Retirement Enrollment Forms | back to top |
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| X | 5/10 | 15 Year Service Catch-Up Contribution Form for the 403(b) | MS Word | Yes | |
| Retirement Forms for Retiring Employees | back to top |
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| 02/12 | ASRS Application for Retirement Benefit | Yes | |||
| 04/10 | Retiree Accumulated Sick Leave (RASL) Form (GAO-SL-50) | Yes | |||
| 04/10 | Retiree Accumulated Sick Leave Checklist for University Employees (Submit with RASL form) |
Yes | |||
| 04/10 | Retiree Accumulated Sick Leave Federal Taxes (Submit with RASL form) |
Yes | |||
| 06/06 | Retiree Accumulated Sick Leave Nationwide - Deferral Notification Form (Submit with RASL form - if applicable) |
Yes | |||
| 03/13 | Retiree Accumulated Sick Leave State Taxes (Submit with RASL form) |
Yes | |||
| 10/12 | 2013 Retiree Health Benefits Enrollment Form - ADOA | Yes | |||
| Termination, Layoff and Non-renewal | back to top |
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| X | 5/08 | Layoff - FTE Reduction (below .50 FTE) Notification Memo Format for Regular Classified Staff (who have completed the initial six month probation) | NEW TEMPLATE HERE | Yes | |
| X | 9/04 | Layoff Notification Memo Format for Regular Classified Staff (who have completed the initial six month probation) | NEW TEMPLATE HERE | Yes | |
| X | 3/06 | Nonrenewal Notification Memos (Appointed Personnel) - Contact your Organizational Consultant | |||
| X | 09/09 | Termination Report | |
This form is no longer in use. Terminations should now be processed though Manager Self Service at: http://uaccess.arizona.edu/ |
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