HR and Payroll Forms

Payroll Forms

• Direct Deposit
• Leave Without Pay Payroll Adjustment Form
• Pay Dates, Payroll Deadlines, Work Calendars
• 403(b)/457(b) Supplemental Retirement Agreement
• Supplemental Retirement STOP Contribution
• W-4- Electronic copy of the W-4 form can be found here

Employee Benefits Forms

Insurance:

• Health, Dental and Life Insurance Application
• Voluntary Life Insurance Application
• Medical Cigna Claim
• Delta Dental Claim
• Vision Out-Of-Network Claim Reimbursement
• Active Voluntary Application (Vision, Short and Long Term Disability)
• NCPERS Prudential Life Insurance (Additional NCPERS forms)
• MASA Ambulance Election Form

Retirement:

• 403(b)/457(b) Supplemental Retirement Agreement (Participant enrollment and contribution changes. Participants in WRS Deferred Compensation should NOT use this form)
• 457(b) Wyoming Retirement System (WRS) Deferred Compensation Plan (Participant enrollment)
• 457(b) Wyoming Retirement System (WRS) Paycheck Contribution Election (Contribution changes)
• Supplemental Retirement STOP Contribution
• Employees’ Group Insurance Direct Payments Agreement
• Retirement Health Insurance Electronic Funds Transfer Form
• Retirement Plan Option Form
• UW Certification of Retirement

Flexible Spending:

• 2024 Flexible Benefits Enrollment
• Flexible Benefits Change Form - midyear only
• Medical & Dependent Care Reimbursement Claim

Other:

• ADA Accommodation Request Form
• FMLA Request
• Health Savings Account Election Form
• Leave Without Pay Request
• Leave Without Pay Payroll Adjustment Form
• Leave With Pay Request
• Sick Leave Donation
• Sick Leave Donation Request
• Termination Leave Option Form
• Tuition Waiver
• Workers' Compensation Injury Report

Classification/Compensation Forms

• Position Description Questionnaire Template

Employment Forms

• I-9 List of Acceptable Documents
• HR Confidentiality Agreement

 Student Employment

• Graduate Assistant Hire Checklist
• Non-Benefited/Student Hire Checklist