Forms A-Z

 

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

 

90-Day Performance Review Form

[Word]

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]

Application for Leave

[Word]

Background Check Release

[PDF]

Biweekly Individual Payroll Summary Form

[Excel]

Change of Address

(Please complete all forms and forward to HR at MUW-1609 or This email address is being protected from spambots. You need JavaScript enabled to view it.)

NOTE: All 3 forms take you away from MUW's website.

1. PERS - if PERS participant.  ORP participants should contact their ORP vendor(s)
2. State and School Employees' Life and Health Plan
3. SABC (Southern Administrators and Benefit Consultants, Inc.)

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 Certification and Authorization Form

[Word]

Employee Time Log

[Word]

Employee vs Independent Contractor Checklist

[Word]

Ethnicity/Race Form (NCES Updated)

[Word]

Flexible Spending Account Claim Form (SABC beginning 2011)

[PDF]

Guardian Application for Dental, Life, and Vision Insurance

[PDF]

Investigation Report (Workers' Comp)

[PDF]

Job Evalution Packet

[Word]

Unused (JEP for PA)

[Word]

Justification and Approval for Adjunct Teaching or Additional Duties (Non-contract Staff)

[Word]

Leave - Application for Leave

[Word]

Leave Form - Exempt Employee Leave Record
(Exempt Employee Leave Information)

[PDF | Excel]

[ PDF ]

Leave Form - Less than 12 months Faculty Leave Record
(Less Than 12 Month Faculty Leave Information)

[PDF| Excel]

[PDF]

Leave Form - Non-exempt Employee Attendance/Leave Record
(Non-exempt Employee Leave Information)

[PDF] Excel]

[PDF]

Leave Donation Eligibility Form

[PDF]

Leave Donation Form

[PDF]

Meal Plan Form

[PDF]

Medical Certification Form (Employee)

[PDF]

Medical Certification Form (Family Member)

[PDF]

New Employee Forms -
Employee Biographical Form


[PDF]

New Employee Forms -
Ethnicity/Race Form

[Word]

Onboarding Checklist for Supervisors

[Word]

Paycheck Authorization Form (Biweekly)

[PDF]

Paycheck Authorization Form (Monthly)

[PDF]

Performance Appraisal - Dean Supervisor

[PDF]

Performance Appraisal - Dept Chair Sup.

[PDF]

Performance Appraisal - Management

[Word]

(Management Competencies)

[Word]

Performance Appraisal - Staff

[Word]

(Staff Competencies) [Word]

Personnel Action Form (PAF)

[PDF | Word (fill-in format)]

Request for Outside Employment - Consultation and Research (Faculty)

[Word]

Request for Outside Employment - (Staff)

[Word]

Sponsored Programs Personnel Action Form (updated 10/09/12)

[ PDF | Word]

Student Worker Time Log

[Word]

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

[PDF]

Tuition Remission Form (Employee/Retiree)

[PDF]

Tuition Remission Form (Dependent Child)

[PDF]

Tuition Remission Form (Spouse)

[PDF]

Vision Claim Form

[PDF]

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.

1100 College Street Columbus, MS 39701phone: 662.329.4750 or 877.462.8439