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    Employment Benefits Compensation Advising Forms Policies

    UA HR Forms Page

    Before downloading any documents, please read about the document formats. Click on the format icon to download the document.

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    Benefits Forms back to top
      04/13 Dependent Information Update Form PDF MS Word  
    10/10 Child of Opposite Sex Domestic Partner Declaration of Tax Status Form PDF    
      08/08 Child of Same Sex Domestic Partner Declaration of Tax Status Form PDF    
    X 12/10 Domestic Partner Change Form PDF MS Word  
     X 11/13 HSA Voluntary Contribution Designation Form PDF  MS Word  
    X 10/12 Flexible Spending Account Election Change Form PDF MS Word  
    X 02/13 Qualified Life Event Form PDF MS Word  
     X 10/10 Qualified Opposite Sex Domestic Partner Affidavit PDF    
      08/08 Qualified Same Sex Domestic Partner Affidavit PDF    
      02/13 Flexible Spending Account Claim Form - ASI PDF    Additional Information
      02/13 Flexible Spending Account Direct Deposit Sign Up Form PDF    Additional Information
    Benefits - Life Insurance Forms back to top
      7/00 ReliaStar Life Insurance - Enrollment Form PDF    
      8/04 ReliaStar Life Insurance - Request for Change Form PDF    
    Child Care Forms back to top
    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
    X 10/05 Discharge Memo Format (For Regular Classified Staff) HTML / MS Word   Additional Information
    X 10/05 Disciplinary Probation Memo Format (For Regular Classified Staff) HTML / MS Word   Additional Information
    X 10/05 Disciplinary Suspension Memo Format (For Regular Classified Staff) HTML / MS Word   Additional Information
    X 05/08 Initial Probation Termination Memo Format (For Classified Staff on Initial Six-Month Probation Period) NEW TEMPLATE HERE   Additional Information
    X 1/07 Investigative Leave with Pay Memo Format HTML / MS Word   Additional Information
    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   Additional Information
    X 09/09 Promotion/Transfer Probationary Period Performance Improvement Memo Format (For Classified Staff on a Promotion/Transfer Probationary Period) NEW FORM HERE   Additional Information
    X 09/09 Promotion/Transfer Probationary Period Termination Notice Format (For Classified Staff on a Promotion/Transfer Probationary Period) NEW FORM HERE   Additional Information
    X 10/05 Written Warning Memo Format (For Regular Classified Staff) HTML / MS Word   Additional Information
    Compensation Forms back to top
    X 8/98 Position Description Format Link  
    X 9/00 Request for In-Classification Career Progression Form PDF MS Word Additional Information
      7/12/01 Supplemental Compensation Form-Appointed Personnel PDF   Additional Information
      7/12/01 Supplemental Compensation Form-Classified Staff PDF   Additional Information
      7/12/01 Supplemental Compensation Form-Graduate Assistants/Associates PDF   Additional Information
    Designated Campus Colleagues (DCC) back to top
    X 11/12 Affiliate Verification Form PDF MS Word  
    X 03/14 Designated Campus Colleague Worksheet   MS Word  
    Leave of Absence Forms back to top
    X 02/13 Compassionate Transfer of Leave Contribution Form  PDF   Additional Information
    X 10/12 Compassionate Transfer of Leave Request Form  PDF   Additional Information
    X 04/11 Employer Response to Employee Regarding Family and Medical Leave PDF MS Word  
    X 9/09 Extended Leave of Absence Form - Classified Staff   MS Word Additional Information
    X 04/11 Family and Medical Leave Request Form PDF MS Word Additional Information
    X 04/11 FML Certification of Health Care Provider PDF MS Word Additional Information
    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
    X 11/01
    3/07
    Extended Temporary Employment Staff Memorandum of Understanding PDF MS Word 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 PDF    
        Request for Revision or Addition to UHAP   MS Word Additional Information
    X 07/09 Request for Time In Position Waiver PDF MS Word Additional Information
    New Employee Packet Forms back to top
    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 PDF MS Word 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 Additional Information
    X 3/07 New Hire Information PDF MS Word  
    X 3/07 Notification of Policies PDF MS Word  
    X 11/10 Person Information Form PDF MS Word  
    X 8/10 Race/Ethnicity/Sex Self-Identification Form PDF MS Word  
    X 12/09 State of Arizona Employee Loyalty Oath PDF MS Word Additional Information
    X 3/07 Veteran/Disability Self-Identification Form PDF MS Word  
    X 10/13 New Health Insurance Marketplace Coverage Notice PDF    
    New Hire/Appointment Forms back to top
    X 8/10 Hiring Form (Competitive and Non-Competitive) PDF MS Word  
    Offer Letters - College of Medicine /UPH  
    X 04/14 University Physicians Healthcare Offer Letter (To be printed on UPH letterhead) Doc  
    Offer Letters - College of Medicine General  
    X 3/12 College of Medicine Clinical Assistant Exception Pay Authorization Form PDF MS Word No
    Offer Letters - College of Medicine Offer Letter Builders   back to top
    X 02/10 College of Medicine Clinical Faculty Offer Letter Builder (University Physicians Healthcare) Link  
    Offer Letter Builders - Classified Staff, Appointed Personnel and Graduate Assistant/Associate back to top
    X 05/11 Classified Staff Offer Letter Builder Link  
    X 05/11 Faculty and Appointed Personnel Offer Letter Builder Link  
        Important information regarding the hiring of development officers.    Additional Information
    X 04/11 Limited-term Faculty Service Offer Letter Builder Link  
    X 04/14 Graduate Assistant/Associate Offer Letter Builder Link   
     
    Performance Evaluation Forms back to top
      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 Additional Information
    X 1/98 Narrative Format / Performance Appraisal   MS Word Additional Information
    X 1/98 Objectives, Factors and Standards Format / Performance Appraisal   MS Word Additional Information
    X 12/06 Performance Feedback for Individual Contributors   MS Word Additional Information
    X 12/06 Performance Feedback for Managers and Supervisors   MS Word Additional Information
    X 1/98 Traditional Eight-factor Report of Performance Appraisal   MS Word Additional Information
    Pre-Employment & Background Checking Forms back to top
      2/05 Adverse Action Notice (Candidate)   MS Word  
      2/05 Adverse Action Notice (Employee)   MS Word  
      3/08 Candidate Consent and Disclosure Form PDF MS Word  
      1/14 Employment Reference Release 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)
     
      2/05 Request for Security Sensitive Status PDF MS Word  
      2/05 Summary of Rights under FCRA PDF MS Word  
      3/05 UA CDL Release Form   MS Word  
    Qualified Tuition Reduction Forms back to top
    X 12/13 Application for Qualified Tuition Reduction - Retirees, UA affiliates and employees on LTD only PDF   MS Word This form is for retirees, UA affiliates and employees on Long Term Disability only. Active employees should apply online in UAccess Employee. Click here for more information.
     X 12/13 Application for Domestic Partner Tuition Program - Retirees only PDF 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
    9/12 Faculty Search Plan Worksheet PDF  MS Word   
    Retirement Enrollment Forms back to top
    5/10 15 Year Service Catch-Up Contribution Form for the 403(b)   MS Word  Additional Information
    Retirement Forms for Retiring Employees back to top
      02/12 ASRS Application for Retirement Benefit PDF   Additional Information
      04/10 Retiree Accumulated Sick Leave (RASL) Form (GAO-SL-50) PDF   Additional Information
      04/10 Retiree Accumulated Sick Leave Checklist for University Employees
    (Submit with RASL form)
    PDF   Additional Information
      04/10 Retiree Accumulated Sick Leave Federal Taxes
    (Submit with RASL form)
    PDF   Additional Information
      06/06 Retiree Accumulated Sick Leave Nationwide - Deferral Notification Form
    (Submit with RASL form - if applicable)
    PDF   Additional Information
      03/13 Retiree Accumulated Sick Leave State Taxes
    (Submit with RASL form)
    PDF   Additional Information
      12/13 2014 Retiree Health Benefits Enrollment Form - ADOA PDF   Additional Information
    Termination, Layoff and Non-renewal back to top
    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   Additional Information
    X 9/04 Layoff Notification Memo Format for Regular Classified Staff (who have completed the initial six month probation) NEW TEMPLATE HERE   Additional Information
    X 3/06 Nonrenewal Notification Memos (Appointed Personnel) - Contact your Organizational Consultant      
    X 09/09 Termination Report  PDF  
    This form is no longer in use. Terminations should now be processed though Manager Self Service at: http://uaccess.arizona.edu/