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Workers' Comp Guide

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EAP Tobacco Quit Seminars

To access the On-Line Forms, Acrobat Reader is required.  To download the current version click on the following link.  *Acrobat Reader

On-Line Forms

Annuity/401(k) Forms

• 403(b) Participation Agreement
• 403(b) Termination Agreement
• 401K Enrollment Forms
• 401(k) Enrollment Form - for new enrollments
• 401(k) Salary Deduction Agreement - for deferral amount increases, decreases, or cancellations
• 401(k) Beneficiary Designation Form - for naming or changing your 401(k) beneficiary
• 401(k) Change Form
• 401(k) Participant Change Request (for name or address changes)

Employee Scholarship Forms

• Faculty/Administrative/Professional/Clerical/Support Staff - Maintenance Fee Payment Application
  Program restored effective Fall 2005
• Fee Discount for Spouse and/or Dependent
• PC 191 - Fee Waiver

Hiring Forms

• Background Check Release Form
• Credential Evaluation Form
• Kroll Notice Authorization and Release Form
• Interview Notes
• Pre-Employment Inquiry Guide
• Recruitment Plan
• Reference Check
• Faculty Recruitment Forms

Miscellaneous Forms

• Absence Form - Faculty
• Absence Form - Staff
• Designation of Beneficiary
• Employee Grievance/Complaint Form
• Employee Document Routing Slip
• Faculty Clearance
• Family and Medical Leave Request
• FMLA Physician Certification Form Employee
• FMLA Physician Certification Form Family Member
• Financial Interests Disclosure Form
• Flexible Spending Account Reimbursement Request Form
• Health Insurance Enrollment/Change Form
• HRS/EXT Security Authorization
• Leave and Annual Salary Security Authorization
• List/Label Request
• Outside Employment Request
• Request for Work Schedule Change
• Request to Inspect/Copy Public Records
• Staff Clearance
• Volunteer Agreement
• New Position & Reclassification Questionnaire

Payroll Forms

• Address Change Form
• Adjunct Pay Authorization
• Direct Deposit Authorization
• Employee Information
• Extended Education Data Entry
• Extra Compensation for Permanent Employees
• Graduate Assistant Data Entry
• I-9 Form- Employment Eligibility Verification
• I-9 Employment Eligibility Verification Handbook
• OT/Compensatory Time Approval
• Participant Enrollment - 401(k) and 457(b) Plans
• Payroll Deduction Authorization
• Parking Deduction Authorization
• Remote Hire Notary Notice (form & instructions)
• Resident Assistant Data Entry
• Salary Deferral Agreement - 457Deferred Compensation Plan
• Temporary Help Pay Request Form
• Temporary/Extra Compensation Timesheet
• Time Entry Departmental Data
• W-4
• W-5 Earned Income Advance Payment Certificate

Sick Leave Bank Guidelines & Forms

• Faculty Sick Leave Bank Guidelines
  Faculty Sick Leave Bank Request
  Faculty Sick Leave Bank Enrollment Form
• Non-Faculty Sick Leave Bank Guidelines
  Non-Faculty Sick Leave Bank Request
  Non-Faculty Sick Leave Bank Enrollment Form
• Sick Leave Donation Agreement

Workers Compensation Forms

• Worker's Compensation Guide and Forms

Office of Human Resources
Austin Peay State University
Browning Building, 002
Box 4507
Clarksville TN 37044
(931) 221-7177
Fax (931) 221-6345

Maintained by Personnel Assistant, HR