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Forms
General
Benefits
Compensation/Classification
Employee Relations
Employment
Human Resource Information Systems
Payroll
PMP
Helpful Hints for Completing the MS Word Interactive Forms
Click on the icon to select either MS Word 
or PDF 
format.
GENERAL
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Employee Assistance Program (EAP) Supervisory Referral Form | |
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UMBC Quarterly Staff Recognition Award Nomination Form |
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UMBC Telework Policy and Agreement |
BENEFITS
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General |
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Change of Name/Address Form | ||
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Tuition
Remission |
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Tuition Remission | |
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Health
Benefits |
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FY 2008 Regular Employee Enrollment Worksheet | ||
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FY 2008 COBRA/LAWP/Contractual Worksheet | ||
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HIPAA Authorization Form | ||
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Certification of Dependent Eligibility | ||
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Full-time Student Certification Form | ||
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Disabled Dependent Certification Form | ||
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Affidavit Required for All Dependents | ||
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Affidavit
Required for Stepchildren NOTE: also requires Affidavit for All Dependents |
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Affidavit
Required for Grandchildren/Legal Wards NOTE: also requires Affidavit for All Dependents |
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Life
Insurance |
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Beneficiary Form for UNUM Provident Term Life Insurance | ||
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Standard Life Insurance Beneficiary Form | ||
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Standard Life Insurance Statement of Health for residents of Maryland | ||
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UNUM Term Life Enrollment Form | ||
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Disability |
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UNUM Long Term Disability Enrollment Form | ||
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Accidental
Death & Dismemberment |
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Met Life Accidental Death & Dismemberment Beneficiary Form | ||
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Flexible
Spending Account |
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Flexible Spending Account Direct Deposit Form | ||
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Health Care Spending Account Claim Form | ||
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Dependent Care Spending Account Claim Form | ||
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Leave |
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Advanced Sick Leave Form Revised 5/07 | ||
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Leave Donation Form Revised 5/07 | ||
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Leave Reserve Fund Request Form | ||
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Request for Extended Sick Leave Form Revised 5/07 | ||
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Request for Family/Medical Leave (FMLA) Form Revised 4/08 | |
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Advanced Vacation Leave Revised 4/08 | |
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Retirement Forms |
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Retirement Plan Selection Form | |
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Supplemental
Retirement Account Change Forms |
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TIAA-CREF 403 (b) | |
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Fidelity 403 (b) | |
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TIAA-CREF 457 (b) | |
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Fidelity 457 (b) | |
COMPENSATION/CLASSIFICATION
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Classification Action Request Form Revised 1/08 | |
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Position Description |
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UMBC Position Request Form Revised 1/08 | |
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Summer Pay Position Request Form Revised 4/08 | |
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Request for Approval of Acting Capacity Status Form |
EMPLOYEE RELATIONS
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Disciplinary Action Form | |
| NOTE: Please contact the Department of Human Resources for technical assistance prior to taking any disciplinary action. |
EMPLOYMENT
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Application |
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Contingent I Requisition Revised 11/06 |
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Contingent I Agreement Revised 11/06 |
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Addendum to Personal Services Contract |
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UMBC Preliminary Recruitment & Selection Report Revised |
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UMBC Hiring Exception Revised 3/07 |
HUMAN RESOURCES INFORMATION SYSTEMS
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Report/Label Request |
PAYROLL
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General
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Direct Deposit | Direct Deposit Information | |
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Savings Bond | Savings Bond Information | |
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I-9 | ||
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Payroll Address | ||
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W-4 - Maryland | W-4 Maryland Instructions | |
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W-4 - Washington DC | ||
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W-4 - West Virginia | ||
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FICA Student Exemption Form |
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PeopleSoft
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New Hire Personnel Action Request (PAR) | |
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New Hire PAR Instructions | |
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HR Security Access Request Form |
Non-Resident Alien (NRA) Forms & Information
Payroll
Preparer Forms & Information
PERFORMANCE MANAGEMENT PROCESS
(PMP)
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PMP Form  |
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PMP Guide
to Defining Performance Ratings |
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 |
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PMP Rating Worksheet (Optional) |
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2006 - 2007 PMP Memorandum |