UTSA Human Resources Forms |
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Benefits |
Benefits Cost Worksheet:
- (2007-2008) [PDF]
- (2006-2007) [PDF]
- (2005-2006) [PDF]
- Fort Dearborn Life Insurance - Evidence of Insurability Application[PDF]
- Short Term / Long Term Disability Application (Employees Only) [PDF]
- (CNA) Evidence of Insurability Long-Term Care, Short and Long Forms [PDF]
- UT Select Medical Insurance - Evidence of Insurability Application[PDF]
- Transitional Benefits Form [PDF]
- Claim Form [PDF]
- Coordination of Benefits [PDF]
- Form to Request Extended Medication Supply [PDF]
- Mail Order Prescription Forms [PDF]
- PayFlex Direct Deposit Authorization Form - PayFlex Systems [PDF]
- PayFlex Give Yourself A Pay Raise! - PayFlex Systems [PDF]
- PayFlex Letter of Medical Necessity Form - PayFlex Systems [PDF]
- UT FLEX Claim Form - PayFlex Systems [PDF]
- UT FLEX Plan Booklet (effective 2002) [PDF]
- Salary Conversion Agreement [PDF]
- Employee & Spouse [PDF]
- Accidental Death & Dismemberment Certificate - Fort Dearborn Life [PDF]
- Group Term Life Certificate - Fort Dearborn Life [PDF]
- Fort Dearborn Life / PAI Brochure - Fort Dearborn Life Insurance [PDF]
- Fort Dearborn Life Beneficiary Designation Form - Fort Dearborn Life Insurance [PDF]
- Benefits Change Of Status Form [PDF]
- Benefits Dependent Form [PDF]
- Incapacitated Child Form [PDF]
- Insurance Enrollment/Change Authorization Form [PDF]
- Leave Without Pay
- Purchase Agreement: Unused Annual Leave Payment to 457 (b) [PDF]
- Waiver of Medical Insurance
- Zip Code Exception Form [PDF]
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Compensation |
- Request for Salary Supplementation
- Faculty Salary Pay Election Agreement [PDF]
- *NEW Job Progression Request
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Employment |
- Criminal Background Check Form
- Direct Deposit Form [PDF]
- Employee Acknowledgement Form [PDF]
- Employment Offer Letter
- I-9 Form
- I-9 - Employers Handbook [PDF]
- New Employee Information Request Form
- New Employee "On-the-Job" Orientation Checklist
- Notice of Voluntary Service
- Political Aid, Legislative Influence and Standards of Conduct [PDF]
- Request for Prior Approval Of Outside Employment
- Selective Service Registration Requirement Form
- W-4 Form - 2007 [PDF]
- W-5 Form - 2007 [PDF]
- W-4 Form - 2008 [PDF]
- W-5 Form - 2008 [PDF]
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Employment Packets |
- Non-Benefits Eligible Employment Packet
- Occasional Employment Packet
- Part-Time / Temporary Employment Packet
- Work Study Employment Packet
- Appointment Worksheet
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Mail Codes |
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FMLA |
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Performance and Evaluation |
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Position Management |
- Position Audit Questionnaire
- Position Description Guideline and Form
- *NEW Progression Determination Worksheet
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Records Services |
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Retirement |
- Authorization for Reduction for Employee Contribution [PDF]
- Authorization for Reduction for Employee Contribution
For Employees Returning to ORP [PDF] - Purchase/Change Agreement [PDF]
- Transfer Verification Form [PDF]
- Authorization to Change Carriers [PDF]
- Cancellation Request
- Purchase Agreement ORP/TSA
- Transfer Verification Form [PDF]
- UT System TSA Disclosure
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Separation / Termination |
- Separation Processing Checklist
- Employee Separation Form
- Purchase Agreement: Unused Annual Leave Payment to 457 (b) [PDF]
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Sick Leave Pool |
- Sick Leave:
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Training and Development |
- Individual Sign-in Form [PDF]
- Course Sign-in Form [PDF]
- Course Evaluation Form [PDF]
- Class Scheduling Form [PDF]
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