Frequently Used Forms
To download Acrobat Reader (open .pdf files), click on the Adobe icon below:
PEDS (Performance Evaluation and Development System)
Online Supervisory Reporting Structure Change Form
HR/Payroll Personnel Action
Downloadable Forms
Hiring Process Forms
Affirmation Statement (.pdf)
Background Check Interactive Form (.pdf)
Interactive Form Help for Background Checks
Hiring Manager Memo
BECR-Faculty Benefited Faculty Change Request Form (.doc)
BECR-Staff Benefited Staff Change Request Form (.doc)
Classified Ad Form (.doc)
Confidentiality Statement Information (.pdf)
Directions for submiting this form online are contained in this document.
I-9 Employment Eligibility Verification Form (English) (.pdf)
I-9 Instruction Presentation (.ppt)
I-9 Employment Eligibility Verification form (Spanish) (.pdf)
Job Description Form -- Faculty (.doc)
Job Description Form -- Staff (.doc)
Patent Agreement Information (.pdf)
Directions for submiting this form online are contained in this document.
PCR-Position and Change Request Form (.doc)
Prospective Faculty Appointment (.doc)
Position Actions Forms
Job Description Form -- Faculty (.doc)
Job Description Form -- Staff (.doc)
PCR-Position and Change Request Form (.doc)
Employee Actions Forms
BES-Benefited Employee Separation Request (.doc)
Change of Address/Name Form (.doc) (For permanent name changes employees must present their social security card to Human Resources along with this form.)
Continuity of Service (.pdf)
Bridge of Service Request Form. Explains Continuity of Service Policy after there has been a break in service.
myWeb - Change of Name (Accessing this site changes the appearance of your name on myWeb only. Simply accessing this site does not make a legal namechange required in our information system for payroll purposes.)
SRE-Special Recognition for Employee Form (.doc)
Payroll Forms
Direct Deposit Form (.doc)
Hand Check Request Form (.doc)
Instructions for Online Payroll Access (Web-for-Employees) (.doc)
W-2 Duplicate Request Form (.doc)
W-4 Employee's Withholding Allowance Certificate (.pdf)
Other Forms
DU Special Community Member Form (.pdf)
Exit Interview Form (.doc)
Sample Bi-Weekly Timesheet And Overtime Report (.xls)
Transfer Exit Interview (.doc)
Volunteer Faculty Set-Up Form (.pdf)
Workers Compensation Release Form (.pdf)
Benefits
Downloadable Forms
Eco Pass Forms
Ecopass Agreement 2012 (.pdf)
Health/Dental Insurance Forms
Benefits Enrollment/Change Form With Instructions (.pdf)
Cancel Medical/Dental/Life Insurance Form (.pdf)
EPIC Hearing Service Plan (.pdf)
HSA Health Plan and Savings Account Information and Forms (.html)
Kaiser HSA - Wells Fargo Reimbursement Request (.doc)
Health Savings Account (HSA) Payroll Deduction Form (.pdf)
Wells Fargo HSA Employee Enrollment Instructions (.pdf)
Preventive Care Services (.pdf)
Leave Forms
Important: If you are anticipating a leave of any kind, please contact
Sarah Childs in the Human Resources Benefits Department at
303-871-3501.
Bereavement Leave Request Form (.pdf)
FMLA Certification of Health Care Provider for Employee (.pdf)
FMLA Certification of Health Care Provider for Family Member of Employee (.pdf)
LRF - Leave Request Form (.doc)
LOA - Leave of Absence Request Form (.pdf)
Parental Leave Pay Schedule (.pdf)
Life Insurance Forms
Hartford Beneficiary Designation Form (.pdf)
Hartford Personal Health Application and Evidence of Insurability Form (.pdf)
Hartford Portability and Conversion Comparison Guide (.pdf)
Hartford Voluntary Life Enrollment Form (.pdf)
Flexible Spending Forms
Planned Benefit Systems (PBS) File a Claim for Reinbursement
Planned Benefit Systems (PBS) All forms
Planned Benefit Systems (PBS) Contact Information:
Planned Benefit Systems Ph: 303-221-2783 (Denver)
P.O. Box 4594 Ph: 800-800-0133 (Toll Free)
Greenwood Village, CO 80155-4594 Fax: 303-221-2785
Website: www.pbs.us.com
Email: help@pbs.us.com
Tuition Waiver Forms
Dependent Tuition Waiver Request Form (.pdf)
Retirement Forms
Frequently Asked Questions: University of Denver 403(b) Retirement Plan
2010 Retirement Maximum Calculation Request Form (.pdf)
Retirement Funds After Separation from Service (.pdf)
Retirement Plan Eligibility Form (.doc)
Retirement Salary Reduction Agreement (.pdf)
TIAA-CREF Retirement Enrollment Form
TIAA-CREF Transfer Rollover Form (.pdf)
Other Forms
Affidavit of Common Law Marriage (.doc)
Affidavit of Domestic Partnership (.pdf)
Statement of Termination of Domestic Partner Relationship (.pdf)
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