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Benefits Forms

Insurance Forms:

Pre-tax insurance enrollment forms must be obtained through the PeopleFirst system. To obtain a form, you can either log into the PeopleFirst website at https://peoplefirst.myflorida.com or contact a Service Center representative at 1-866-663-4735.

Blue Cross/Blue Shield Claim Form

Caremark Drug Claim Form

Caremark Mail Order Prescription Form

Health Insurance Enrollment Form

Health Savings Account Application

Group Life Claim for Total Disability - Employee Statement

Group Life Claim for Total Disability - Employer Statement

Group Life Disability Attending Physician's Statement

Minnesota Life Insurance Beneficiary Form

Life Insurance Death Benefits Claim Form

Life Insurance Policy Conversion Form

Life Insurance Portability Election Form

Long Term Disability Application (Submit to Human Resources)

Long Term Disability Evidence of Insurability

Pre-Tax Premium Waiver Form

Qualifying Status Change (QSC) Form

Reimbursement Accounts (FSA) Claim Form

Spouse Program Enrollment Form

Unum Disability Claim Form

Retirement Forms:

Direct Deposit Form for Retirees

FRS Application for Disability Retirement

Fidelity Application (403(b) and/or Roth 403(b))

Fidelity Funds (Available to UCF Participants)

ORP-16 Form [for new enrollees]

ORP-16A Form [for changes to existing ORP accounts]

Salary Reduction Agreement (Non-ORP)

Salary Reduction Agreement (ORP)


Other Benefits Forms:

Florida Prepaid College Plan Form

New Employee Orientation Schedule - 2006

Savings Bonds Payroll Authorization or Cancellation Form

Tuition Waiver Program

Compensation Forms

Employment Certification Form (A&P and Faculty)

On-Call Form

Perquisite Form (Excel)

Perquisite Instructions

Position Description - A&P

Position Description -  USPS

Position Description Instructions

Post Doctoral Agreement (9189)

Shift Differential Form

Employee Recognition Forms

Davis Productivity Awards Form

Gabor Excellence Award Nomination Form

Employee of the Month Form

Employee Relations Forms

Arbitration Request Form - Rule 6C7-3.033 (USPS)

Conflict of Interest, Outside Activity/Employment Report (A&P/USPS)

Conflict of Interest, Outside Activity/Employment Report (Faculty)

Employee Exit Questionnaire

Non Unit Faculty and A&P Grievance Form (Word)

Performance Appraisal - A&P Annual Review

Performance Appraisal - Certified Law Enforcement

Performance Appraisal - USPS

Permission to Use University Personnel, Equipment, Facilities, Students, or Services (A&P/USPS)

Position Exemption Worksheet - Confidential Employee

USPS Grievance Form

Leave of Absence

Certification for Qualifying Exigency

Intent to Return to Work and Medical Release

Leave of Absence Checklist

Leave of Absence Request

Medical Certification for Covered Service Member with a Serious Health Condition

Medical Certification for Employees Serious Health Condition

Medical Certification for Family Member’s Serious Health Condition

Military Leave Checklist

Medical or Parental Leave Checklist

Medical or Parental Leave Form

Volunteer Service Agreement

Workers' Compensation Forms

Claim Reporting Proceedure

First Report of Injury Form

Instructions for completing First Report of Injury

Mileage Claim Form

Workers Compensation Checklist

Sick Leave Pool

USPS Sick Leave Pool Open Enrollment Application

USPS Sick Leave Pool Request Form

Payroll Services Forms

Cell Phone Allowance Form

Departmental Cost Center Authorization List

Direct Deposit Authorization Form

Human Resources Security Request Form (formerly Payroll Certification Security Access Form)

Leave Audit Forms (Excel)

Off Cycle Check Request Form

On-Call Form

Paycheck Pick Up Authorization

PBA Leave Payout Request Form

Request for Compensatory Leave Payout

Request for UCF Dual Compensation

Retroactive Payment Request Form

Timesheet Helper (TSHelper)

Twelve-Month Payment Option Form

Under 30 Days Form (Payment of Personal Services)

W-4

W-5

Records Forms

Confidentiality Agreement for Employees

Confidentiality Agreement for Vendors/Volunteers

Contracted Graduate Assistants - Offer of Appointment

Degree Information Update Form

Employee Acknowlegement

Employment Questionnaire for Students

Employment Verification Request Form

Exit Checklist - All Employees

Foreign National Information Form

I-9 Form (Employment Eligibility and Verification)

Loyalty Oath

Notice of Drug-Free Schools and Drug-Free Workplace Policy

On-Call Form

Orientation Notice

Personal Data Sheet

Post Doctoral Agreement (9189)

Public Records Request

Request for UCF Dual Compensation

Resignation Form

Supplemental Assignment Form (for Graduate Students)

Recruitment Forms

A&P Online Employment Application

Applicant Data Survey - Faculty

Background Investigation Form - Student Employees/Volunteers

CareerBuilder Advertisement Form

Degree Information Update Form

Employment Certification Form (For Faculty Positions Only)

Faculty Disclosure and Release of Information Authorization Form

Hiring Freeze Exemption Request Form

Online Requisition Form

Online Security Access Form

Position Vacancy Announcement (for Faculty positions only)

Request for Interview Records

Search Committee Meeting Notice

Staff (USPS) Online Employment Application

Staff (USPS) Physical Exam Form

Telecommuting Program Forms

Telephone Reference Check (PDF)

Telephone Reference Check (Word)

Time-Limited Appointment Memorandum

Training Forms

Training Registration On-line Form

Last modified: 5 June 2009
Human Resources Webmaster

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