Forms A-Z

NOTE: Some of these form links will take you to a site away from the MUW website.

Background Check Release AuthorizationCall Human Resources x7222
Banner Access RequestElectronic Form is available on the ITS Website. Select Banner, then Banner Access Request.
Banner Self-Service Instructions:
Pay Stubs[PDF]
W-2[PDF]
BENEFIT Forms: 
Benefits Election Form (all benefits EXCEPT State & School Employees’ Health/Life) [PDF]
Claim FormsDental (Guardian), Vision (Davis), Disability, Term Life (call HR Generalist x7222)
Accident, Dental, Vision, Voluntary Life AD&DGuardian Booklet 2026
Cancer, Critical Illness, Disability, Term LifeOther Optional Insurance Information
State & School Employees’ Health Insurance ApplicationHealth PDF
State & School Employees’ Life Insurance ApplicationLife PDF
State & School Employees’ Life Insurance Beneficiary Designation (Minnesota Life/Securian)Instructions to change your beneficiary are on the MS DFA Website. Link takes you off-site.
State & School Employees’ Health Insurance & CVS Caremark Online RegistrationInstructions for Online Registration
Confidentiality Agreement[PDF]
Deferred Pay Form (Faculty)[PDF]
Direct Deposit Authorization FormCall Human Resources x7222
Employee Certification and Authorization Form[Word]
Employee Date Change Form
(For name, address, phone, email changes)
Call Human Resources x7222
Employee Personal Information Form[PDF]
Employee Transfer/Separation Checklist – Current Department[Word]
Employee Transfer Checklist – Receiving Department[Word]
Employee Time Log (For all Benefits-Eligible Biweekly Employees)
Email cajernigan1@muw.edu for a copy of the time log.
Employee vs Independent Contractor Checklist[PDF]
Flex Time Request Form[PDF]
Health Savings Account Enrollment Form[PDF]
Job Evaluation Packet[PDF] To maintain fillable fields, use the save option vs printing as a pdf. Email hrinfo@muw.edu if you don’t have this option.
Justification and Approval for Adjunct Teaching or Additional Duties (Staff)[PDF]
Leave – Application for Leave[PDF]
Leave – Instructions for Entering & Approving Leave in Banner Self-Service and Leave FAQs[PDF]
Leave Form – Biweekly Non-Exempt Employee Attendance/Leave Record[Excel] or email cajernigan1@muw.edu for a copy of the12-month master spreadsheet.
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 Guidelines[PDF]
Meal Plan Form[PDF]
Medical Certification Form (Employee)[PDF]
Medical Certification Form (Family Member)[PDF]
Onboarding Checklist for Supervisors[Word]
Outside Employment Request Form (Faculty)[Word] | [PDF]
Outside Employment Request Form (Staff)[Word] | [PDF]
Paid Parental Leave Request Form (Primary Caregiver)[PDF]
Personnel Action Form (PAF)[PDF]
PERS Form 4A [PDF]
Reasonable Accommodations Request Form[PDF]
Release to Return to Work from Medical Related Leave[PDF]
Sponsored Programs Personnel Action Form (SPPAF) [PDF]
Student Worker Time Log (Time Entry Time Sheet – Use as Excel Document – Do Not Handwrite)
[Excel]
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 CertificateForm W-4 2025 Link takes you off-site.
Tax Form – Mississippi Withholding Exemption CertificateMS Tax Withholding Form Link takes you off-site.
Teleworking – Job Analysis[Word]
Teleworking – Temporary Agreement[Word]
Tuition Remission Form (Employee/Retiree, Dependent Child, Spouse)Forms are available on the Financial Aid Forms Webpage.
Veteran’s Self-Identification Post-Offer Form[PDF]
Voluntary Self-Identification of Disability Form[PDF]
Workers’ Comp FormFirst Report of Injury (Form & Instructions) Complete all applicable yellow highlighted boxes and SUBMIT TO THE HUMAN RESOURCES OFFICE.[PDF]