Forms A-Z

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

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]
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 2026 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]