These Human Resources forms are now available for download as Adobe .PDF files. If you do not have a copy of Adobe's Acrobat Reader currently installed on your PC you will need to download and configure your free copy before working with these files. This is a one time process which will then permit you to view and print these and other .PDF formatted publications on the Web. Please follow the installation and browser configuration instructions provided by Adobe.

The following Human Resources forms have been designed to allow you to fill in the form on your computer using Adobe Acrobat Reader version 4.0 or higher. Double click on the form you wish to complete. Use the tab key to move from field to field in the form. When you have completed the form, print it and mail to the appropriate office. Click on the blue Reset Form button to return to a blank form.

MISCELLANEOUS

Change of Address/Phone Form

Clearance Form

EDR - Employee Disciplinary Report Form

Extra Compensation Request Form

Summer Extra Compensation Request (9- and 10-month employees) See Instructions on Page 2 of form.

2008 Form W-4 Federal Tax Withholding Form Fill in form, print, sign and mail to Payroll Office, Murray State University, Murray, KY 42071.

Kentucky Revenue Form K-4 State Tax Withholding Form Fill in form, print, sign and mail to Payroll Office, Murray State University, Murray, KY 42071.

Retiree Account Request Form

BENEFITS

Flexible Benefits Claims Forms

WageWorks Health Care Reimbursement Account Claim Form

WageWorks Dependent Care Reimbursement Account Claim Form

Health Insurance Claims Forms

Anthem Blue Cross Blue Shield Claim Form

Anthem Blue Cross Blue Shield Student Verification Form

Tax Shelter

Tax Sheltered (403b) Salary Reduction Form

EMPLOYMENT

New Hire Checklist for Supevisors

Temporary Hire Instructions/Forms

Background Check Disclosure Form

I-9 Form - Employment Eligibility Verification, INS, U.S. Department of Justice

Hiring - Non-exempt Positions

Hiring Procedures for Non-Exempt (Hourly) Positions

Suggested Interview Guidelines

Pre-Employment Inquiries

Employment Summary Form for Hourly Positions

Request to Fill Position Vacancy Form for Hourly Positions

Performance Evaluations

Non-exempt Performance Appraisal Instructions

Exempt Position Description Guidelines

Professional Staff (Exempt) Position Description Format (Word document)

TUITION WAIVER

MSU Tuition Waiver Form - to be used by Murray State employees to request waiver of tuition for classes taken at Murray State

State Tuition Waiver Form - to be used by non-Murray State employees of Kentucky post-secondary institutions for waiver of tuition on courses taken at Murray State

CPE Tuition Waiver Program - to be used by supervising and resource teachers for waiver of tuition on courses taken at Murray State University.

SICK LEAVE BANK

Sick Leave Bank Certification Form

Sick Leave Bank Discontinuation Form

Sick Leave Bank Enrollment Form

Sick Leave Bank Request Form

FMLA

FMLA Form Certification for Employee - Health Care Provider

FMLA Form Certification for Family Member - Health Care Provider

FMLA Form Certification for Service Member

FMLA Form Certification for Service Member - Qualifying Exigency

FMLA Form - Designation Notice

FMLA Form - Employer Response to Employee Request

FMLA Form - Request for Leave

WORKERS' COMPENSATION

Instructions for Completion of IA-1

First Report of Injury or Illness, Form 1A-1 (Attachment A)

Fraudulent Claim/State Information Sheet

Medical Waiver and Consent, Form 106

Workers' Compensation Prescription Program (eMeric, Inc)

Lost Time and Return to Work Form WCF-1 (Attachment D)

Sick Leave - Workers' Compensation, Form WCF-2 (Attachment E)

Instructions for Completion of WCF-5, Report of Medical Status

Physician's Instructions for report of Medical Status, Form WCF-5

Commonwealth of Kentucky/CCMSI, Inc. - Report of Medical Status, Form WCF-5, (Attachment F)

Request for Payment for Services or Reimbursement for Compensable Expenses, Form 114 (Attachment G)

Provider Introductory Letter

Notice of Designated Physician

Notice of Second Designated Physician