Benefits Forms
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Child of Domestic Partner Declaration of Tax Status Form |
PDF |
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Dependent Information Update Form |
PDF |
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Flexible Spending Account Claim Form - ASI |
PDF |
Additional Information |
Flexible Spending Account Direct Deposit Sign Up Form |
PDF |
Additional Information |
Flexible Spending Account Election Change Form |
PDF |
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HSA Voluntary Contribution Designation Form |
PDF |
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ORP Change of Election Form |
PDF |
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Qualified Domestic Partner Affidavit |
PDF |
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Qualified Life Event Form |
Word Doc |
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Termination of Domestic Partnership |
PDF |
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Child-Care Forms
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Childcare Choice Employee Reimbursement Program for Qualified Childcare Expenses |
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See LWC website |
Childcare Choice - Employee Enrollment Verification Form |
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See LWC website |
Sick Child and Emergency/Back-Up Care Program for Employees |
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See LWC website |
Sick Child and Emergency/Back-Up Care Program for Students |
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See LWC website |
Designated Campus Colleagues (DCC)
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Affiliate Verification Form |
PDF |
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Designated Campus Colleague Worksheet |
MS Word |
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Intermittent Volunteer Agreement (Macro-enabled Word document) |
MS Word |
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Intermittent/Occasional Volunteer Worksheet |
MS Word |
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Intern-Department Worksheet |
MS Word |
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Leave of Absence Forms
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Compassionate Transfer of Leave Request Form |
PDF |
Additional Information |
Compassionate Transfer of Leave—Request to Forfeit Vacation Hours |
PDF |
Additional Information |
Extended Leave of Absence Form - Classified Staff & University Staff |
MS Word |
Additional Information |
FMLA: Certification for Serious Injury or Illness of a Current Servicemember - For Military Family Leave |
PDF |
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FMLA: Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave |
PDF |
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FMLA: Certification of Health Care Provider for Employee’s Serious Health Condition |
PDF |
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FMLA: Certification of Health Care Provider for Family Member’s Serious Health Condition |
PDF |
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FMLA: Certification of Qualifying Exigency for Military Family Leave |
PDF |
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FMLA: Designation Notice |
PDF |
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FMLA: Employee Request for Family and Medical Leave |
PDF |
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FMLA: Notice of Eligibility and Rights & Responsibilities |
PDF |
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Leave Of Absence Unpaid - Appointed Personnel: Template For Department Head Approval/Denial of Employee Request |
Template |
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Leave Of Absence Unpaid - Appointed Personnel: Template For Department Request to the Provost |
Template |
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Leave Of Absence Unpaid - Appointed Personnel: Template For Employee Request to Department Head |
Template |
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Paid Parental Leave |
MS Word
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New Hire Forms
** These forms are only used for processing approved exceptions to the new hire process in UAccess. **
The individual forms listed below are also contained in the
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Employment Eligibility Verification Form I-9 (Fillable electronically). Note: with some browsers you may get a "please wait" error message. Simply click "download" from this error page. The form will download to your device, where you can open it. |
Link |
Additional Information |
Employment Eligibility Verification Form I-9 (This version is unfillable and must be printed for completion on paper only.) |
PDF |
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Hiring Form (Competitive and Non-Competitive) |
PDF |
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New Health Insurance Marketplace Coverage Notice |
PDF |
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New Hire Worksheet |
MS Word |
Additional Information |
Person Information Form |
PDF |
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Self Identifier Ethnicity |
PDF |
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State of Arizona Employee Loyalty Oath |
PDF |
Additional Information |
Veteran Status |
PDF |
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Voluntary Self ID of Disability |
PDF |
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Offer Letters
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University Staff Offer Letter Builder |
Template |
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COM Offer Letter |
MS Word
|
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Faculty and Appointed Personnel Offer Letter Builder |
Template |
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Graduate Assistant/Associate Offer Letter Builder |
Link |
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Limited-term Faculty Service Offer Letter Builder |
Template |
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Tenure Eligible/Continuing Eligible Review Date Calculator |
Link |
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Pre-Employment & Background Checking Forms
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Background Screening Consent Form |
PDF |
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Background Screening Disclosure Form |
PDF |
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Employment Reference Release Form |
MS Word |
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Summary of Rights under FCRA |
PDF |
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Request for Criminal Background/DMV Check (for Positions not Maintained in Talent) |
Online Form |
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Request for Security Sensitive Status |
PDF |
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Qualified Tuition Reduction Forms
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Application for Domestic Partner Tuition Program - Retirees only |
PDF |
This form is for retirees only. Active Employees should apply online in UAccess Employee. Click here for more information. |
Application for Qualified Tuition Reduction - Retirees lacking online access and employees on LTD only |
PDF |
This form is for retirees,and employees on long-term disability only. Active employees and affiliates should apply online in UAccess Employee. Click here for more information. |
Retirement Forms
Retirement forms have been moved to the Road Ahead website.
UAccess Employee
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Electronic Manager Self Service (MSS) Forms |
Link |
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PAF (Personnel Action Form) |
Link |
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