Human Resources Forms/Documents

NEW! Request for Job Transfer Form
NEW! Remission of Fees
NEW! Flex Time Arrangement
NEW! Payroll and Employee Reimbursement Form
Job Description Form
Health Risk Assessment (HRA)
Comprehensive Performance Management Process (CPMP)
Report of Absence Log
Six-month Probationary Appraisal
Momentum 125: Performance-Based Compensation Initiative
Health Insurance Form
Life Insurance Form
Change of Address Form
Campus Directory Information Form
Change of Name Form
Outside Employment Form
Biographical Sketch Info 1 | 2

The PERS Form Library

• Form 1 - Enrollment Form
• Form 1B - Beneficiary Nomination
• Form 1C - Change of Information
• Form 4A - Noncovered Employment Acknowledgement
• Form 4B - Certification/Acknowledgement of Reemployment of Retiree
• Form 5 - Application for Refund of Accumulated Contributions to Member
• Form 5W - Request for Emergency Waiver of 45 Days for a Refund of Accumulated Contribution Subject to Regulation 44
• Form 17 - Certification of Withholding Preference
• Form 18 - Employer Certification of Termination and Unused Leave
• Form 19 - Out-of-State Certification
• Form 25A - Acknowledgement of Right to Purchase Service Credit Under the Veteran's Reemployment Rights Law
• Form 25M - Statement of Qualified Military Service

Report of Absence of University Employees Form

Tax Forms

• Form W-4 Employees Withholding Allowance Certificate
• Mississippi Employee's Withholding Exemption Certificate - Form 89-350-98-1
• Earned Income Credit

Undergraduate Tuition Remission Policy for Dependents of Faculty and Staff

Worker's Compensation First Report of Injury Form