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University of Alaska HR Forms

Please click on a category below, or the menu to the left for the forms, or click here for a legend of the different file type icons.

Jump to HR Office Use Only Forms

Employee Forms:

Benefits Forms:
Beneficiary Designation
Campus Card Deduction Form
Financially Interdependent Partners (FIP) Explanation
Financially Interdependent Partners (FIP) Statement
FSA Claim For Medical And Dependent Care
FSA Direct Deposit For Medical And Dependent Care Form
Student Enrollment Verification/Dependent Health Care Eligibility
TDA Salary Reduction Agreement
(Tuition) Waiver Request - UA Education Benefit
UA Approved Courses for Spring 2009
UA Choice Enrollment Guide
UA Choice Health Plan Enrollment Form
UA Choice Opt-Out Form
UA Choice Supplemental Benefit Election Form
UA Supplemental Life Evidence of Insurability Form
Waiver Request - UA Education Benefit

Employment Forms:
Change Form
Demographic - Personal Data
Employee Work Activity Outside of Alaska Form
Employment of Immediate Family Member Disclosure Form
Employment or Service Outside UA Disclosure Form
I-9 Form
Injury/Illness Form (Previous)
Social Security Card Application (External Site)
Social Security Exemption for Temporary Employees
Student Employee Waiver Form
Student Status Verification
UA Computer Account Request Form
UA System Administrative Access Request Form
W-4 Form
W-5 Form

Ethics Forms:
Alaska Administrative Code
Alaska Executive Branch Ethics Act Quick Reference
Employment of Immediate Family Member Disclosure Form
Employment or Service Outside UA Disclosure Form
Employment or Service Outside UA Memo
Ethics Act Compliance Regarding "Works" - UNAC Faculty
Ethics Determination Request Form
Ethics Disclosure - Notification of Receipt of Gift
Ethics Worksheet Answer Guide
Executive Branch Ethics Act - Worksheet

Flexible Spending Account Forms (FSA):
FSA Claim For Medical And Dependent Care Form
FSA Direct Deposit For Medical And Dependent Care Form
UA Choice Supplemental Benefit Election Form
UA Supplemental Life Evidence of Insurability Form

Health Forms:
Blue Cross Claim Form
Caremark Prescription Claim Form
COBRA Rights and Responsibilities Summary
Financially Interdependent Partners (FIP) Explanation
Financially Interdependent Partners (FIP) Statement
FML Q & A's
FML Request Form
FML: Certification of Health Care Provider for Employee's Serious Health Condition
FML: Certification of Health Care Provider for Family Member's Serious Health Condition
FML: Certification of Qualifying Exigency for Military Family Leave
FML: Certification for Serious Injury or Illness of Covered Servicemembers - for Military Family Leave
FSA Claim For Medical And Dependent Care Form
FSA Direct Deposit For Medical And Dependent Care Form
Student Enrollment Verification/Dependent Health Care Eligibility
UA Choice Health Plan Enrollment Form
UA Choice Opt-Out Form
UA Choice Supplemental Benefit Election Form
UA Supplemental Life Evidence of Insurability Form
VSP Out-of-Network Reimbursement Form

Leave Forms:
FML Q & A's
FML Request Form
FML: Certification of Health Care Provider for Employee's Serious Health Condition
FML: Certification of Health Care Provider for Family Member's Serious Health Condition
FML: Certification of Qualifying Exigency for Military Family Leave
FML: Certification for Serious Injury or Illness of Covered Servicemembers - for Military Family Leave
Leave Share Donation Form
Leave Share Transfer Request Form
Leave Without Pay Request Form (FMLWOP, SLWOP, LOAWOP)

Nonresident Alien Forms (NRA):
1042s Country Codes
1042s Form Reprint Request
8233 Form
8233 Form Attachments
8233 Form Instructions
Day Counter (for substantial presence test)
Day Counter - Leap Year (for substantial presence test during leap years)
fsaATLAS Access Request Form
GOA2TAX Entry
GOAINTL Entry
Independent Contractor
International Form
International Scholarship Form
NRA - FAQ's
NRA - Foreign Entity Form
NRA - IRS Regulations for Foreign Nationals
NRA - Procedures NRA Scholarship Withholding Worksheet
NRA Workteam Contact Listing
Social Security Card Application (External Site)
Social Security Consent for Release of Information (SSA-3288 Form)
Tax Treaty Summary - Personnel/Payroll Related
Tax Treaty Summary - Scholarship/Fellowship Related
Tax Treaty Withholding Summary - Accounts Payable
Visa Classifications
Visa Waiver Program (VWP)
W-8BEN Form
W-8BEN Instructions
W-8ECI Form
W-8ECI Instructions
W-8EXP Form
W-8EXP Instructions

Payroll Forms:
Automatic (Direct) Deposit Request Form
Campus Card Deduction Form
Direct Deposit Request Form
Employee Selected Deduction Form
Employee Work Activity Outside of Alaska Form
Salary Advance Request Form
Social Security Card Application (External Site)
Social Security Exemption for Temporary Employees
Timesheet Exempt
Timesheet Nonexempt
W-4 Form
W-5 Form

Retirement & Pension Forms:
PERS/TRS Forms (External Site)
PERS/TRS/ORP Option
Pension/ORP Fund Sponsor Enrollment/Change Form (Faculty, Staff, and Executives)
Retirement Plan Decision Tree (Regular Faculty or Academic Executives)
Retirement Plan Decision Tree (Regular Staff or Non-Academic Executives)
Retirement Plan Election Form (Regular Faculty, Staff, and Executives)
Retirement Plan Notification Form (Regular Staff or Non-Academic Executives)
Retirement Plan Notification Form (Regular Faculty or Academic Executives)
TDA Salary Reduction Agreement
TIAA-CREF Online Enrollment Guide
TIAA-CREF ORP Account Enrollment Form
TIAA-CREF Transfer/Rollover Authorization Form
TIAA-CREF UA Pension Plan Enrollment Form
Fidelity Beneficiary Designation Form
Fidelity Address/Name Change
Fidelity Online Enrollment Guide
Fidelity Transfer/Rollover Form
Fidelity Voluntary TDA, ORP, & Pension Plan Enrollment Form

Risk Management Forms: External Site
Student accident, auto claim, release and waiver, etc.

Union Forms:
UAFT Disability Leave Bank Application for Withdrawal
UAFT Service Fee Deduction Form
UAFT Service Fee Revocation Form
UAFT Upper Division Release
Local 6070 Membership Dues or Fees Deduction
United Academics Adjuncts AAUP/AFT Dues Deduction
United Academics Dues or Agency Fee Deduction
United Academics Dues or Agency Fee Revocation