MISCELLANEOUS FORMS
Address/Name Change Form
Application for Fee
Remission Authorization Form
Direct Deposit Form
Leave Request Form
Performance
Appraisal Cover Sheet
Probationary Appraisal Form
Tuition Remission Dependent Authorization Form
Vacation/Sick Leave Summary
HEALTH AND BENEFITS FORMS
Domestic Partner Benefits Forms
Domestic Partner Certification Checklist
Domestic Partner Health Enrollment Form
Affidavit
of Domestic Partnership
Certification
of Tax-Qualified Dependents
Termination of Domestic Partnership
Health Enrollment and Claim Forms
19-26
Adult Child Certification Form *only needed if
making changes
26-28
Adult Child Certification Form *required
26-28 Adult
Child Affidavit Form *required
26-28
Adult Child Health Enrollment Form *required
Anthem
Medical
(out of network) Claim Form
Dental Claim Form
Flexible Spending Agreement Form
Flexible Spending Account Claim Form
Family and Medical
Leave Application
Health Insurance Enrollment/Change Form Instructions
Health Insurance Enrollment/Change Form
Health Insurance Enrollment/Change Form for Bargaining Unit Faculty only
Health Savings Reduction Form
HSA
Employee
Contribution Form
Life Insurance Beneficiary Change Form
Medicare Secondary
Payer Act Status Form
Orthodontic Claim Form
Prescription Claim Form
Vision (out of network) Claim Form
WellPoint NextRx Prescription Drug Claim Form (HDHP Plan
Retirement
Forms
Alternative Retirement Plan (ARP) Election Form
COMPENSATION FORMS
Classified Job Audit Form
Personnel Action Form
Position
Description Form (PDF)
Position
Description Form (Word)
Salary Adjustment Request Form
Starting Salary Request Form
Unclassified
Position Review Request Form
Unclassified
Position Review Decision Form
TAX FORMS
Federal Tax Form
State of Ohio Tax Form
|
