Human Resources Forms

The forms listed on the following pages can either be filled out online and then printed or printed and filled out by hand.

Forms are in Microsoft Excel and/or Adobe Acrobat Portable Document Format (.pdf) format. In order to fill out .pdf forms online, you must have Adobe Acrobat or Adobe Reader version 4.0 or higher. If you use Adobe Reader you WILL NOT be able to save your files; you can only fill and print the forms. To download a free copy of the current version of Adobe Reader, click on the Acrobat Reader icon below and following the simple online instructions.

Form	Form Number	Format	Last Update
Additional Pay	UM 271	.pdf *	7/13/2010
Completion Instructions			7/13/2010
Additional Pay	UM 271	Excel	7/13/2010
Administrative Posts	UM 268	.pdf *	6/27/2005
Completion Instructions			6/27/2005
Application For Student Employment	UM 52	.pdf *	2/17/2010
Appointment Notification	UM 269	.pdf *	2/17/2010
Completion Instructions			1/3/2005
Faculty Pay Option	UM 269a	.pdf *	8/17/2005
Authorization For Educational Assistance	UM 84-1	.pdf*	8/17/2011
Completion Instructions
Authorization For Educational Fee Reduction For Spouse and Dependents	UM 85	.pdf*	8/17/2011
Biweekly Payroll Time Sheets
Biweekly Payroll Time Record	UM 13A	Excel	8/23/2009
Completion Instructions		.pdf *	8/23/2009
Biweekly Payroll Time Record - Comp Time Version	UM 13A-C	Excel	8/23/2009
Completion Instructions		.pdf *	8/23/2009
Biweekly Payroll Time Record - Non Benefit Eligible	UM 13NB	Excel	7/1/2005
Completion Instructions			11/8/2005
Car Mileage Log	UM 15	Excel	12/6/2011
Change of Address/Telephone Number	UM 282	.pdf *	4/30/2003
Completion Instructions			4/30/2003
Data Form For Retired Staff	UM 270R	.pdf *	8/2/2005
Completion Instructions			8/2/2005
Direct Deposit	UM 32B	.pdf *	2/17/2010
Educational Assistance Program for Retired Employees	UM 177	Excel *	6/3/2011
Questions and Answers		.pdf *	5/14/2007
Employee Separation Check List	UM 325	.pdf *	5/14/2007
Completion Instructions		.pdf *	5/14/2007
FMLA
Definition of Terms			8/30/2004
Your Rights Under the Family and Medical Leave Act (WHD Publication 1420)		.pdf	4/15/2009
Certification of HealthCare Provider for Employee Serious Health Condition	UM 410	.pdf *	4/15/2009
Eligibility Notice (For Department HR/Management Use Only)		.doc *	8/23/2009
Designation Letter (For Department HR/Management Use Only)		.doc *	8/23/2009
Certification of HealthCare Provider for Family Member’s Serious Health Condition	UM 411	.pdf *	4/15/2009
Certification of Qualifying Exigency for Military Family Leave	UM 412	.pdf *	4/15/2009
Certification for Serious Injury or Illness of Covered Servicemember–for Military Family Leave	UM 413	.pdf *	4/15/2009
Foreign Visitor Tax Assessment Intake Form	UM 374	.pdf *	2/27/2004
JED Continuation	UM 270A	.pdf *	7/23/2003
Monthly Absence Summary	UM 60A	Excel	3/11/2010
Monthly Absence Summary	UM 60A	.pdf *	3/13/2010
Completion Instructions			3/11/2010
Nonresident Alien Honoraria/Business Expense Supporting Statement	UM 378	.pdf *	11/3/2008
On-Line Check Request	UM 140	Excel	8/26/2009
Completion Instructions			8/26/2009
PAFs
Personnel Action Form	UM 270	.pdf *	11/24/2009
Completion Instructions			11/24/2009
PAF For Courtesy Appt. and Volunteers	UM 376	.pdf *	4/30/2009
Completion Instructions			4/30/2009
PAF For Nonresident Aliens Not Employed	UM 376A	.pdf *	2/17/2010
Payroll Correction Form - Hourly Paid Completion Instructions	UM 30B	Excel	6/13/2008 11/11/2008
Payroll Correction Form - Salaried Employees Completion Instructions	UM 30A	Excel	6/13/2008 11/11/2008
Performance Review Form	UM 29B	.pdf *	7/8/2004
Performance Review Form	UM 29B	Excel	6/22/2009
Completion Instructions		.pdf *	5/14/2007
Personal Data Form	UM 272	.pdf *	12/15/2011
Completion Instructions		.pdf *	6/26/2006
Request For Extra Compensation	UM 273	.pdf *	5/31/2008
Request For Leave of Absence	UM 108	.pdf *	1/20/2009
Completion Instructions			8/30/2004
Staff Volunteer Information Sheet	UM 275	Excel	7/1/2011
Student Employees FICA Checklist	UM 284	.pdf*	11/2/2006
Completion Instructions			8/17/2005
Request For President's Approval For New Appointment	UM 368	.pdf *	11/1/2002
E-Verify, I-9 and W-4s
E-Verify - The University of Missouri is required by state law to participate in the federal E-Verify program for all new hires. (Contact your campus Human Resources Services for more information.)
E-Verify Exception Request	UM 400	.pdf*	3/13/2009
E-Verify Exception Process Instructions			3/13/2009
Posters should be displayed so that each new hire has the opportunity to view them. If display is not feasible, then you must distribute to each new hire.
E-Verify Poster - English		.pdf*	3/13/2009
E-Verify Poster - Spanish		.pdf*	3/13/2009
E-Verify Right to Work Poster - English		.pdf*	3/13/2009
E-Verify Right to Work Poster - Spanish		.pdf*	3/13/2009
I-9 Employment Eligibility Verification	I-9	.pdf *	4/3/2009
Completion Instructions			8/15/2003
Federal Employee's Withholding Certificate	W-4	.pdf *	1/3/2012
Missouri Employee's Withholding Certificate	MO W-4	.pdf *	1/3/2012
Union Eligible Employees Only
Request and Authorization for Deduction of Organization Dues	UM 71	.pdf *	3/31/2008
Request and Authorization for Deduction of Organization Dues	UM 71	Excel	3/31/2008
Withdraw of Authorization for Deduction of Organization Dues	UM 70	.pdf *	6/21/2007
Withdraw of Authorization for Deduction of Organization Dues	UM 70	Excel	6/21/2007

Reviewed 2012-04-27.