Benefits Forms
| Child of Domestic Partner Declaration of Tax Status Form |
PDF |
|
| Dependent Information Update Form |
PDF |
|
| 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 |
|
| HSA Voluntary Contribution Designation Form |
PDF |
|
| Optional Retirement Plan Change of Election Form |
PDF |
You may change authorized investment providers once per year. |
| Qualified Domestic Partner Affidavit |
PDF |
|
| Qualified Life Event Form |
PDF |
|
| Termination of Domestic Partnership |
PDF |
|
Child-Care Forms
| Childcare Choice Employee Reimbursement Program for Qualified Childcare Expenses |
|
See LWC website |
| Childcare Choice - Employee Enrollment Verification Form |
|
See LWC website |
| Sick Child and Emergency/Back-Up Care Program for Employees |
|
See LWC website |
| Sick Child and Emergency/Back-Up Care Program for Students |
|
See LWC website |
Coaching and Discipline
Compensation Forms
Designated Campus Colleagues (DCC)
| Affiliate Verification Form |
PDF |
|
| Designated Campus Colleague Worksheet |
MS Word |
|
| Intermittent/Occasional Volunteer Agreement (Macro-enabled Word document) |
MS Word |
|
| Intermittent/Occasional Volunteer Worksheet |
MS Word |
|
| Intern-Department Worksheet |
MS Word |
|
Leave of Absence Forms
| 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 |
MS Word |
Additional Information |
| FMLA: Certification for Serious Injury or Illness of a Current Servicemember - For Military Family Leave |
PDF |
|
| FMLA: Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave |
PDF |
|
| FMLA: Certification of Health Care Provider for Employee’s Serious Health Condition |
PDF |
|
| FMLA: Certification of Health Care Provider for Family Member’s Serious Health Condition |
PDF |
|
| FMLA: Certification of Qualifying Exigency for Military Family Leave |
PDF |
|
| FMLA: Designation Notice |
PDF |
|
| FMLA: Employee Request for Family and Medical Leave |
PDF |
|
| FMLA: Notice of Eligibility and Rights & Responsibilities |
PDF |
|
| Leave Of Absence Unpaid - Appointed Personnel: Template For Department Head Approval/Denial of Employee Request |
Template |
|
| Leave Of Absence Unpaid - Appointed Personnel: Template For Department Request to the Provost |
Template |
|
| Leave Of Absence Unpaid - Appointed Personnel: Template For Employee Request to Department Head |
Template |
|
| Paid Parental Leave |
MS Word
|
|
Miscellaneous Forms
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 New Hire Forms Packet (PDF).
| Employment Eligibility Verification Form I-9 (Fillable electronically) |
Link |
Additional Information |
| Employment Eligibility Verification Form I-9 (This version is unfillable and must be printed for completion on paper only.) |
PDF |
|
| Hiring Form (Competitive and Non-Competitive) |
PDF |
|
| New Health Insurance Marketplace Coverage Notice |
PDF |
|
| New Hire Worksheet |
MS Word |
Additional Information |
| Person Information Form |
PDF |
|
| Self Identifier Ethnicity |
PDF |
|
| State of Arizona Employee Loyalty Oath |
PDF |
Additional Information |
| Veteran Status |
PDF |
|
| Voluntary Self ID of Disability |
PDF |
|
Offer Letters
| Classified Staff Offer Letter Builder |
Template |
|
| College of Medicine Clinical Assistant Exception Pay Authorization Form |
PDF |
|
| COM Offer Letter |
MS Word |
|
| Faculty and Appointed Personnel Offer Letter Builder |
Template |
|
| Graduate Assistant/Associate Offer Letter Builder |
Link |
|
| Limited-term Faculty Service Offer Letter Builder |
Template |
|
Performance Feedback Forms (Career Conversations)
In partnership with the UA community, the Division of Human Resources reimagined the University's approach to performance feedback. Career Conversations are structured discussions between employees and their supervisors that are designed to support employee success through reflection, planning, problem solving, and honest and constructive feedback. We welcome your comments and ideas to further refine this approach. For more information, check out the Career Conversations Guide or contact the Division of Human Resources at 520-621-3660 and hrsolutions@email.arizona.edu.
Pre-Employment & Background Checking Forms
| Background Screening Consent Form |
PDF |
|
| Background Screening Disclosure Form |
PDF |
|
| Employment Reference Release Form |
MS Word |
|
| Summary of Rights under FCRA |
PDF |
|
| Request for Criminal Background/DMV Check (for Positions not Maintained in UACareers or Career Track) |
Online Form |
|
| Request for Security Sensitive Status |
PDF |
|
Qualified Tuition Reduction Forms
| 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
| Electronic Manager Self Service (MSS) Forms |
Link |
|
| PAF (Personnel Action Form) |
Link |
|
Termination, Layoff and Non-renewal
