NOTE: Some of these form links will take you to a site away from the MUW website.
|
AFLAC Claim Form (This form is for Mississippi residents only. If you live in another state, please contact Human Resources for the correct form.) |
[PDF] |
|
Background Check Release |
[PDF] |
|
Biweekly Individual Payroll Summary Form |
[Excel] |
|
Change of Address |
E-mail your change of address to This email address is being protected from spambots. You need JavaScript enabled to view it. |
|
Confidentiality Agreement |
[PDF] |
|
Deferred Pay Form (Faculty) |
[Word] |
|
Deferred Pay Form (Staff) |
[Word] |
|
Dental Claim Form (Guardian) |
[PDF] |
| Disability (Voluntary) Insurance Forms | |
|
- Highlight Sheet |
[PDF] |
|
- Rates |
[PDF] |
|
- Enrollment Application |
[PDF] |
|
- Disability Evidence of Insurability Form |
[PDF] |
|
Employee Biographical Form |
[Word] |
|
Employee Certification and Authorization Form |
[Word] |
|
Employee Time Log (For all Benefits-eligible Biweekly Employees Except Police) |
Email This email address is being protected from spambots. You need JavaScript enabled to view it. for a copy of the time log. |
|
Employee vs Independent Contractor Checklist |
[Word] |
|
Ethnicity/Race Form (NCES) |
[Word] |
|
Flexible Spending Account Claim Form (SABC beginning 2011) |
[PDF] |
| Flex Time Approval Form | [Excel] |
|
Guardian Application for Dental, Life, and Vision Insurance |
[PDF] |
|
Job Evalution Packet |
[Word] |
|
Justification and Approval for Adjunct Teaching or Additional Duties (Non-contract Staff) |
[Word] |
|
Leave - Application for Leave |
[Word] |
| Leave - Approver Instructions |
[PDF] |
|
Leave Form - Biweekly Non-exempt Employee Attendance/Leave Record |
|
| Leave Correction/Late Forms: | |
| Exempt Employee Form | [Excel] |
| Less Than 12 Month Faculty Form | [Excel] |
| Non-Exempt Employee Form | [Excel] |
|
Leave Donation Eligibility Form |
[PDF] |
|
Leave Donation Form (Staff) |
[PDF] |
|
Leave Donation Form (Faculty) |
[PDF] |
| Leave - Entering Leave or Submitting With No Time Used Instructions |
[PDF]
|
|
Leave Quick Facts |
[PDF] |
|
Meal Plan Form |
[PDF] |
|
Medical Certification Form (Employee) |
[PDF] |
|
Medical Certification Form (Family Member) |
[PDF] |
| Mississippi Affordable College Savings Program (MACS) Payroll Deduction Form | [PDF] |
|
Notice of Intention to Return from Medical Related Leave |
[Word] |
|
Onboarding Checklist for Supervisors |
[Word] |
|
Paycheck Authorization Form |
[PDF] |
|
Personnel Action Form (PAF) |
|
| Reasonable Accommodations Request Form | [Word] |
|
Request for Outside Employment - Consultation and Research (Faculty) |
[Word] |
|
Request for Outside Employment - (Staff) |
[Word] |
|
Sponsored Programs Personnel Action Form (updated 10/09/12) |
|
|
Student Worker Time Log |
[PDF] |
| Summer Flex Program Guidelines, Examples, and FAQs | [PDF] |
| Summer Flex Schedule Request Form | [Excel] |
|
Tax Deferred Annuity Form (for new TDA or change) |
[PDF] |
|
Tax Form - Form W-4 Employee's Withholding Allowance Certificate |
[PDF] |
|
Tax Form - Mississippi Withholding Exemption Certificate |
http://www.dor.ms.gov/Forms/89350158.pdf |
|
Tuition Remission Form (Employee/Retiree) |
Form is available on the Financial Aid website under Forms. |
|
Tuition Remission Form (Dependent Child) |
Form is available on the Financial Aid website under Forms. |
|
Tuition Remission Form (Spouse) |
Form is available on the Financial Aid website under Forms. |
| Veteran's Self-Identification Form | [Word] |
|
Vision Claim Form |
[PDF] |
| Voluntary Self-Identification of Disability Form |
Link takes you to an off-site link. |
|
Workers' Comp Form - First Report of Injury (Form & Instructions) NOTE: DO NOT USE "SUBMIT TO AMFED" BUTTON. FORMS SHOULD BE PROCESSED THROUGH THE HUMAN RESOURCES OFFICE. |
[PDF] |
|
Workers' Comp Form - Investigation Report (Workers' Comp) |
[PDF] |
Notes:
- PDF format is PRINT ONLY which requires free Acrobat Reader
- Right click on "Excel or Word file" and save the file to a local directory
- For Word Fill-in Forms - Save form to your computer, in Word, on the "Forms" toolbar, click the "lock" or "protect form" once document is open.
