Frequently Used Forms

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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 (.doc)

BECR-Faculty Benefited Faculty Change Request Form (.doc)

BECR-Staff Benefited Staff Change Request Form (.doc)

Classified Ad Form (.doc)

Confidentiality Agreement (.pdf)

I-9 Employment Eligibility Verification Form (.pdf)

Job Description Form (.doc)

MBTH-Monthly/Biweekly Temporary Hire and Termination Form (.doc)

MHOT-Monthly Non Benefited Hire or Termination Form (.doc)

Patent Agreement (.pdf)

PCR-Position and Change Request Form (.doc)

Prospective Faculty Appointment (.doc)

Position Actions Forms

Job Description Form (.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.)

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 (.doc)

Exit Interview Form (.doc)

Performance Review Form - Revised (PRDS) (.doc)

Sample Bi-Weekly Timesheet And Overtime Report (.xls)

Transfer Exit Interview (.doc)

Volunteer Faculty Set-Up Form (.doc)

Workers Compensation Release Form (.pdf)

Leave Forms

Important: If you are anticipating a leave of any kind, please contact
Meaghan Burns in the Human Resources Benefits Department at
303-871-3501.

FMLA Certification of Health Provider (.pdf)

LRF - Leave Request Form (.doc)

LOA - Leave of Absence Request Form (.pdf)

Parental Leave Pay Schedule (.pdf)

Benefits

Downloadable Forms

Health/Dental Insurance Forms

Benefits Enrollment/Change Forms (.pdf)

Cancel Medical/Dental/Life Insurance Form (.pdf)

Dental Enrollment Packet (.pdf)

EPIC Hearing Service Plan (.pdf)

HSA Health Plan Acknowledgement of Rights and Limitations (.pdf)

HSA Health Plan and Savings Account Information and Forms (.html)

ID Theft Assistance Plan Enrollment

Kaiser HSA - Wells Fargo Reimbursement Request (.doc)

Salary Reduction Agreement for Health Savings Account (HSA) Contributions (.pdf)

Wells Fargo HSA Employee Enrollment Information Brochure (.pdf)

Wells Fargo HSA Employee Enrollment Form (.pdf)

Life Insurance Forms

Hartford Personal Health Application and Evidence of Insurability Form (.pdf)

Hartford Portability and Conversion Comparison Guide (.pdf)

Hartford Voluntary Life Enrollment Form (.doc)

Flexible Spending Forms

Flexible Spending Account Enrollment/Renewal Form (.dot)

Flexible Spending Account Reimbursement (.pdf)

Flexible Spending Direct Deposit Authorization (.pdf)

Flexible Spending Application for Debit Card (.pdf)

Tuition Waiver Forms

Certification of Job Relatedness Form (.pdf)

Dependent Tuition Waiver Request Form (.pdf)

Employee Tuition Waiver Request Form (.pdf)

Retirement Forms

American Century 403(b) Plan Account Application (.pdf)

Fidelity Investments 403(b) Enrollment Form (.pdf)

Retirement Funds After Separation from Service (.pdf)

Retirement Plan Eligibility Form (.pdf)

Retirement Salary Reduction Agreement (.pdf)

TIAA-CREF Retirement Annuity (Basic RA Plan) Enrollment Form (.pdf)

TIAA-CREF Group Supplemental Retirement Annuity Enrollment Form (GSRA) (.pdf)

Other Forms

Affidavit of Common Law Marriage (.pdf)

Affidavit of Domestic Partnership (.pdf)