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

http://www.dor.ms.gov/docs/WH_89350138.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

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