Human Resources

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

NOTE: Form takes you away from MUW's website.

State and School Employees' Life and Health Plan Change of Address

 

 

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 (For all Benefits-eligible Biweekly Employees Except Police and Resources Management)

[Excel]

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]

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 - Approver Instructions

[PDF]

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

[PDF] Excel]

[PDF]

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

[PDF]

Leave - Entering Leave or Submitting With No Time Used Instructions

[PDF]

 

Leave Guidelines

[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]

New Employee Forms -
Employee Biographical Form


[PDF]

New Employee Forms -
Ethnicity/Race Form

[Word]

Notice of Intention to Return from Medical Related Leave

[Word]

Onboarding Checklist for Supervisors

[Word]

Paycheck Authorization Form

[PDF]

Personnel Action Form (PAF)

[PDF | Word (fill-in format)]

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)

[ 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

http://www.dor.ms.gov/Forms/89350158.pdf

Tuition Remission Form (Employee/Retiree)

Form is available on the Financial Aid website under Forms.

Financial Aid Forms

Tuition Remission Form (Dependent Child)

Form is available on the Financial Aid website under Forms.

Financial Aid Forms

Tuition Remission Form (Spouse)

Form is available on the Financial Aid website under Forms.

Financial Aid 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.

http://www.dol.gov/ofccp/regs/compliance/sec503/Self_ID_Forms/VoluntarySelf-ID_CC-305_ENG_JRF_QA_508c.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.

Human Resources

Melanie Freeman
Director

Whitfield Hall, Second Floor

Mailing: 1100 College Street, MUW-1609, Columbus, MS  39701
Phone: (662) 329-7222
Fax: (662) 241-7616

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.