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Numeric List of Forms

Revised January 4, 2011

University System forms are designated by "UM." Federal forms are designated with one letter (W-4, I-9). Campus and department forms are not included on this list.

Note: Packages and pads contain 25 forms, and orders for indicated forms must be in multiples of 25.

Form #DateForm Title Unit Source of Supply
I-9 Aug 09
Employment Eligibility Verification Pkg Forms Web Page
W-4 Jan 11 Federal and State Withholding Form Pkg Forms Web Page
UM 5

Aug 10

Vehicle Accident Report
Forms Web Page
UM 8 Jun 02 Stores Requisition Pkg Campus Storeroom Website
UM 9 Jun 95 Advice of Gift Received Set Campus Development
UM 9A May 77 Advice of Gift Received - Short Form Set Campus Development /Forms Web Page
UM 11 Jan 11 Travel - Trip Expense Detail
Forms Web Page
UM 11A Jan 11 Travel - Daily Expense Detail
Forms Web Page
UM 12 Jul 04 Supplemental Accounting Voucher
Forms Web Page
UM 13A Aug 09
Bi-Weekly Payroll Time Record,
Forms Web Page
UM 13A-C Aug 09 Bi-Weekly Payroll Time Record - Comp Time Version
Forms Web Page
UM 13NB Jul 05 Bi-Weekly Payroll Time Record - Non-Benefit Eligible
Forms Web Page
UM 17 Jan 11 Employee Moving Expense Reimbursement Request
Forms Web Page
UM 19 Jan 03 Organizational Structure DeptID Change Request
Forms Web Page
UM 20 Jan 03 Organizational Structure Change Request
Forms Web Page
UM 22 Sep 05 Wire Transfer Authorization
Forms Web Page
UM 25 Jan 04 Petty Cash Purchase
Forms Web Page
UM 26 Jul 04 Credit Memorandum and Return Receipt Pkg Campus Storeroom Website
UM 27 Apr 08 Property Inventory and Change Report
Forms Web Page
UM 29B Oct 97 Performance Review Form
Pad Forms Web Page
UM 30A
Jun 08
Payroll Correction Form - Salaried Employees

Forms Web Page
UM 30B
Jun 08
Payroll Correction Form - Hourly Paid Employees

Forms Web Page
UM 32B Feb 10 Direct Deposit Pad Forms Web Page
UM 34 May 06 Transmittal of Records to University Records Center Each Forms Web Page
UM 34A Mar 04 Transfer Records to Archives Each Records Center
UM 48 Jul 01 Internal Order Form
Forms Web Page
UM 50A Sep 04 Harland Deposit Supply Order – Columbia Campus
Forms Web Page
UM 50B Sep 04 Harland Deposit Supply Order - Hospital
Forms Web Page
UM 52 Feb 10 Application for Student Employment
Forms Web Page
UM 53 Mar 99 Assumption of Risk & Release Form
Forms Web Page
UM 54 Jul 04 Bid Summary
Forms Web Page
UM 55 Jul 10 Meningococcal Vaccination Policy Compliance Form
Forms Web Page
UM 60 Apr 02 Report of Absence Pkg Records Center
UM 60A Mar 10 Monthly Absence Summary
Forms Web Page
UM 69 Jan 09 Damage Report
Forms Web Page
UM 70 Jun 07 Withdraw of Authorization for Deduction of Organization Dues
Forms Web Page
UM 71 Mar 08 Request and Authorization for Deduction of Organization Dues
Forms Web Page
UM 72 Nov 05 Vehicle Usage Log
Forms Web Page
UM 73 Nov 05 Vehicle Fuel Log
Forms Web Page
UM 74 Nov 05 Vehicle Maintenance Log
Forms Web Page
UM 81 May 03 Book Stores Requisition Pkg Campus Storeroom
UM 84-1 May 07 Educational Assistance Program Questionnaire & Authorization Form
Forms Web Page
UM 85 Nov 09 Authorization for Educational Fee Reduction for Spouse and Dependents
Forms Web Page
UM 107 Dec 06 Authorization for Payroll Deduction Each Campus Development
UM 108 Jan 09 Request for Leave of Absence
Forms Web Page
UM 121 Sep 90 Records Center Box Label Each Records Center
UM 140 Aug 09
On-Line Check Request
Forms Web Page
UM 155 Apr 10 Disappearance of Assets and Money
Forms Web Page
UM 161 Aug 09
Request for Change in Budget
Forms Web Page
UM 176A Dec 91 Records Destruction Box Labels Each Records Center
UM 177 Jun 07 Educational Assistance Program for Retired Employee
Forms Web Page
UM 200 Dec 10 Student or General Public Injury & Property Report
Forms Web Page
UM 260 Aug 03 University Printing Services Work Authorization Pkg Records Center/ Printing Services Web Page
UM 268 Jun 5 Administrative Posts
Forms Web Page
UM 269 Feb 10 Appointment Notification
Forms Web Page
UM 270 Nov 09
Personnel Action Form
Forms Web Page
UM 270A Jul 03 JED - Continuation
Forms Web Page
UM 270R Jul 05 Data Form for Retired Staff
Forms Web Page
UM 271 Jul 10 Additional Pay
Forms Web Page
UM 272 Feb 10 Personal Data Form
Forms Web Page
UM 273
May 08
Request for Extra Compensation

Forms Web Page
UM 282 Jun 06 Change of Address/Telephone Number
Forms Web Page
UM 284 Nov 06 Student Employees FICA Checklist
Forms Web Page
UM 325 May 07 Employee Separation Checklist
Forms Web Page
UM 326 Jan 10 Benefits Enrollment Form Pad Faculty & Staff Benefits Web Page
UM 326A Jan 09 Benefits Enrollment Change Form Pad Faculty & Staff Benefits Web Page
UM 326B Mar 06 Beneficiary Designation Form Pad Faculty & Staff Benefits Web Page
UM 328 Aug 01 Faculty Performance Shares Option Exercise Request Notice A
Faculty & Staff Benefits Web Page
UM 329 Aug 01 Faculty Performance Shares Option Exercise Request Notice B
Faculty & Staff Benefits Web Page
UM 330 Aug 07 Voluntary Salary Deferral Agreement
Faculty & Staff Benefits Web Page
UM 341 Jul 08
Salary Reduction Agreement Each Faculty & Staff Benefits Web Page
UM 341A
Jul 08
Roth (403b) Salary Reduction Agreement/Disclosure

Faculty & Staff Benefits Web Page
UM 353 Sep 02 Accounting Recurring Voucher Detail
Forms Web Page
UM 357 Feb 92 Forms Printing Request Pkg Forms Management
UM 362 Apr 02 Request for Return of Record from Records Center/Out Card Each Records Center /Forms Web Page
UM 365 Feb 92 Records Center Box Contents Each Records Center /Forms Web Page
UM 365A Feb 92 Records Center Box Contents - Continuation Each Records Center /Forms Web Page
UM 367 Jan 92 Record Center Location Label Each Records Center
UM 368 Oct 02 Request for President's Approval for New Appointment
Forms Web Page
UM 374 Nov 99 Foreign Visitor Tax Assessment Intake Form
Forms Web Page
UM 376 Apr 09 Personnel Action Form for Courtesy Appointments and Volunteers
Forms Web Page
UM 376A Feb 10 Personnel Action Form (PAF) for Non-Resident Aliens Not Employed
Forms Web Page
UM 377 Jun 97 Out Card - Top Tab Each Records Center
UM 377A Jun 97 Out Card - Side Tab Each Records Center
UM 378 Nov 08 Non-Resident Alien Expense Supporting Statement
Forms Web Page
UM 400
Mar 09
E-Verify Exception Request

Forms Web Page
UM 410
Apr 09
Certification of HealthCare Provider for Employee Serious Health Condition

Forms Web Page
UM 411
Apr 09
Certification of HealthCare Provider for Family Member's Serious Health Condition
Forms Web Page
UM 412
Apr 09
Certification of Qualifying Exigency for Military Family Leave

Forms Web Page
UM 413
Apr 09
Certification for Serious Injury or Illness of Covered Service Member - for Military Family Leave

Forms Web Page
UM WC-1 Jan 09
Report of Injury
Forms Web Page


Medical Insurance Claim Form
Faculty & Staff Benefits Website


Dental Insurance Claim Form
Faculty & Staff Benefits Website


Prescription Claim Form Pad Faculty & Staff Benefits Website

Reviewed 2013-10-21.