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Forms and Checklists

A

Academic and Student Hire Checklist

Additional Pay Form

Application for Student Employment

Appointment Notification Form

B

Beneficiary Designation Form

Benefit Change Form

Benefit Enrollment Form

C-D

CFM Performance Appraisal Form

UM Choice Medical Claim Form (Coventry)

Delta Dental Claim Form (Beg 2011)

Direct Deposit Form (UMKC)

Direct Promotion Announcement Template

E

Educational Assistance Form

Employee Exit Checklist (Updated)

Employee Self Appraisal Form

Express Scripts Prescription Drug Claim Form

Express Scripts Prescription Mail-In Form

F

Faculty Pay Option Form

(ASI) Flexible Spending Account Claim Form and Instructions

(ASI) Flexible Spending Account Mid-Year Change Form

Foreign Visitor Tax Assessment Intake Form

G H I

Group Life Evidence of Insurability Form

HIPAA Authorization for Release of Health Information Form

I-9 Employment Eligibility Verification Form

J K L

The JO Passport Enrollment/Cancellation Form

Kansas City City Tax Exemption Form

KCATA TRIP Enrollment/Cancellation Form

Long Term Disability Evidence of Insurability Form

M

UM Choice Medical Claim Form (Coventry)

Monthly/Biweekly Changes Form

N

New Employee Orientation Checklist

Nonresident Alien Honoraria/Business Expense Supporting Statement

Notice of Intent to Retire Form

O P

On-line Check Request Form

Other Leaves of Absence Request Form

Payroll Correction Form – Hourly

Payroll Correction Form – Salaried

Performance Appraisal Form

Personal Data Form

Personnel Action Form (PAF)

Personnel Action Form For Courtesy Appointments and Volunteers

Position Classification Questionnaire (PCQ) Form

Position Management Action Form

Public Transit Benefit Enrollment-Cancellation Form

Proof of Relationship Form

Q R

Reference Check Form

Request and Authorization for Deduction of Organization Dues Form

Request for Duplicate W-2 Form

Request for Extra Compensation Form

Request for Leave of Absence Form*

-Academic: This form is required for all leave requests

-Staff: This form is required for all leave requests with the exception of FMLA

S

Student Employees FICA Checklist

Summer Earn Code Calculator

Supplemental-Optional Life Insurance Change/Cancellation Form

Supplemental-Optional Life Insurance Beneficiary Designation Form *

Supplemental-Optional Life Insurance Enrollment & Evidence of Insurability Form *

* Please Note: these two forms must be completed and submitted together.

 

T U V W X Y Z

Temporary Pay Increase Form

Tuition Reduction for Spouses and Dependents Form

VSP Out-of-Network Reimbursement Form

W-4 Federal Employee’s Withholding Allowance Certificate Form

W-4 Missouri Employee’s Withholding Allowance Certificate Form

Withdraw of Authorization for Deduction of Organization Dues Form