Forms A to Z

Kristen Manes  |  8/30/2018 4:55:12 PM

Following is an alphabetical listing of the Human Resource-related forms. To help in locating a form, some of the same documents are listed with multiple names. Click on the appropriate letter to locate the document you desire.



To search by area of interest, click here .




A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



A
Academic Leave Certification Form for Sick Leave
Accident Protection Plan Enrollment/Change Form
Accidental Death and Dismemberment (AD&D) Enrollment/Change Form

Address and/or Name Change Form - Employment Records
Address Change - La. State Employees' Retirement System
Address Change - Teachers' Retirement System of La.
Alien Tax Information Request Form
Annual Leave Accrual Rate Election Form


B (Return to Top)
Beneficiary and/or Name Change Form - Prudential Life Insurance
Beneficiary Designation and Change Form - LSU Life (UnitedHealthcare)
Beneficiary Designation and Change Form - CSRS
Beneficiary Designation and Change Form - Prudential Life Insurance

Beneficiary Designation Form - La. State Employees' Retirement System
Beneficiary Designation Form - Teachers' Retirement System of La.
Beneficiary Designation Form - Louisiana Deferred Compensation Plan
Benefits Schedule Booklet



C ( Return to Top)
Calculator for Funded and Unfunded Service
Campus Federal Credit Union Payroll Deduction Form
Car Insurance Agreement-LCES
Civil Service Employment Application
Civil Service Position Description - PDF or Word

Critical Illness Enrollment/Cancellation Form

Critical Illness Request for Portability

Coursework Request Form
CSRS Application for Retirement
CSRS Beneficiary Designation and Change Form

CSRS Refund of Contributions Application


D (Return to Top)
Deferred Compensation Plan Enrollment & Salary Deferral Agreement

Dental Enrollment/Cancellation Form
Direct Deposit Form (Payroll Check)
Direct Deposit Waiver (Payroll Check)
Driver Record Verification and Vehicle Authorization Form
Drug Policy (Illegal Use Of) PS-18


E (Return to Top)
Employment in a Job Not Covered by Social Security (SSA-1945)
Employment of a Minor Form
Employment Packet Request -PDF
Employment Screening Form - PDF or Word
Ethics Training Flyer

Exit Checklist

Extension Benevolent Life Insurance - Beneficiary Designation
Extension Benevolent Life Insurance - Enrollment Form


F (Return to Top)
Faculty Job Description Form (PS-46) - PDF
Family Medical Leave Act (FMLA) Notification Form
Family Medical Leave Act (FMLA) Medical Certification Form

Financial Protection Enrollment/Cancellation Form

Flexible Benefits Plan Medical FSA Claim Form - BoonChapman
Flexible Benefits Plan Dependent FSA Claim Form - BoonChapman

Flexible Benefits Plan Enrollment Form
Flexible Benefits Plan Status Change Form


G (Return to Top)
GB-01 - Group Benefits Enrollment/Change Form
GI-1 - Benefits Coverage While on Leave Without Pay Election Form
GB-79 - Health Savings Account Enrollment and Payroll Deduct Election/Change form



H ( Return to Top)
H1B Extension - Unit Instructions - PDF or Word
H1B New Petition - Unit Instructions - PDF or Word
Health Insurance Enrollment/Change Form (GB-01)
Health Insurance Portability Law Form
Health Savings Account Enrollment - Payroll Deduct Election/Change form
Housing Agreement



I (Return to Top)
I -9 Form - Employment Eligibility Verification Form
International Visitor - Request for Arrangements - PDF or Word
Interview and Selection Process
Interview Form - Extension Agent
Interview Selection Requirements for Agents


J (Return to Top)
J1 Exchange Visitor Extension - Unit Instructions
J1 Exchange Visitor Obtaining Visa - Unit Instructions
J1 Exchange Visitor Insurance Statement
J1 Request for Arrangements for J1 EV Applicant Packet


K (Return to Top)


L (Return to Top)
L-4 - Louisiana State Tax Form - Employee Withholding Certificate
L-4E - Louisiana State Tax Form - Exemption From Withholding
LASERS - LA State Employees' Retirement System Address Change
LASERS - LA State Employees' Retirement System Beneficiary Designation
LASERS - LA State Employees' Retirement System Enrollment Form
LASERS - LA State Employees' Retirement System Name Change Form
LASERS - LA State Employees' Retirement System Refund Contributions Form
LASERS - LA State Employees' Retirement System Refund Rollover Form
LASERS SSA-1945 (Employment in a job not covered by Social Security)
Leave Accrual Election Form
Leave Without Pay - Benefits Coverage Election (GI-1)
Letter of Demotion for Classified Employees (SAMPLE)

Letter of Resignation and Exit Checklist

Letter to Applicant not Selected for Position (SAMPLE)

Life Insurance (LSU System, UnitedHealthcare) Enrollment/Cancellation Form

Life Insurance (LSU System, UnitedHealthcare) Beneficiary Designation/Change Form

Life Insurance (LSU System, UnitedHealthcare) Request for Portability

Long Term Disability Enrollment/Change Form

Long Term Disability Portability Request Form

Louisiana Deferred Compensation Plan Enrollment & Salary Deferral Agreement

LSU First Critical Illness Cash Benefit Claim Form


M (Return to Top)
Medical Certification


N (Return to Top)
Name and/or Address Change Form - Employment Records
Name and/or Beneficiary Change Form - Prudential Life Insurance
Name Change - La. State Employees' Retirement System
Name Change - Teachers' Retirement System of LA
Name Tag Information
New Employee Orientation Checklist
New Employee Orientation Schedule and Registration


O (Return to Top)
Offer Letter - Agent
Offer Letter - Associate
Offer Letter - Postdoctoral Researcher

Offer Letter - Professor (Research)

Offer Letter Unclassified
Optional Insurance Election Form
Optional Retirement Plan (ORP) Enrollment/Change Form
Orientation Checklist for New Employees
Orientation Schedule and Registration Form

Outside Employment Disclosure Form - PM-11 Forms A & B


P (Return to Top)
Payroll Schedule - Student

Payroll Schedule - Wage

PER 1B - Personnel Action Form (Can use to attach Job Description in HRS) - PDF or Word
PER 17 - Turn Around Document
Performance Evaluation Form - Civil Service, Transitional - Word
Performance Evaluation Form - Associate/Postdoc Researcher - PDF or Word
Performance Evaluation Form - Non-Classified - PDF or Word
PM-11 Outside Employment Disclosure Forms A & B
PS-18 Illegal Use of Drugs or Alcohol
PS-37 Return to Work Following Illness or Injury
Portability Law - Health Insurance
Position Advertisement and Selection Record - PDF or Word
Position Description - Civil Service - PDF or Word
Promotion/Tenure Review Request Form - Word or PDF
Prudential Life Beneficiary and/or Name Change Form
Prudential Life Beneficiary Designation and Change Form
Prudential Life Claim Form
Prudential Life Evidence of Insurability Form
Prudential Life Insurance Enrollment Form


Q (Return to Top)


R (Return to Top)
Research Associate Supplemental Job Description Form - PDF or Word

Resignation Letter and Exit Checklist
Retirement Election Form - Temporary or Part-time Employee
Retirement Eligibility Chart - All Systems
Refund of Contribuitons - Federal Civil Service Retirement System
Refund of Contributions - LASERS
Refund of Contributions - LASERS - Rollover Authorization
Refund of Contributions - Teachers' Retirement System of La.
Retirement - TRSL or ORP ... How Do I Choose?
Return to Work Policy (After Illness or Injury) - (PS-37)


S (Return to Top)
Sabbatical/Educational Leave Request Form
Schedule of Employee Benefits Booklet
Selective Service Verification Instructions
Sick Leave Certification Form - Academic Employees
SSA.-1945 (Employment in a job not covered by SS)
SSA-1945-LASERS
SSA-1945-TRSL
Stop Payment Request
Student Employment Application
Student Employment - Intent to Employ a Minor
Student Timesheet - PDF or Word
Supplemental Employment Form

Supplemental Retirement Account Election/Salary Reduction Authorization Form

Supplemental Retirement Account - 457 and 403b Overview Info.
Supplemental Timesheet (Form AS420)
Supporting Documents Required for Appointments


T (Return to Top)
Tax Saver Flexible Benefits Plan Enrollment Form
Tax Saver Flexible Benefits Plan Status Change Form
Tax Saver Flexible Benefits Plan Medical FSA Claim Form

Tax Saver Flexible Benefits Plan Dependent FSA Claim Form

Tax Treaty (Form 8233)
Tax Treaty Example Sheet

Tax Withholding - Federal W-4

Tax Withholding - State L-4
Tax Withholding - State L-4E (Exemption From Withholding)
Tax Withholding Example for Non-Resident Aliens

TRSL Teachers' Retirement System of La. Address Change Form
TRSL Teachers' Retirement System of La. Beneficiary Designation
TRSL Teachers' Retirement System of La. Enrollment Form

TRSL Teachers' Retirement System of La. Forfeiture of Benefits
TRSL Teachers' Retirement System of La. Name Change Form
TRSL Teachers' Retirement System of La. Refund of Contributions
TRSL Teachers' Retirement System of LA. SSA-1945 (Job not covered by SS)

Thrift Savings Plan Election/Change Form
Thrift Savings Plan Catch-Up Contribution Form
Timesheet - Bi-Weekly - PDF or Word
Timesheet - Student - PDF
Timesheet - Supplemental (Form AS420)
TN Canadian Status - Obtain TN Status and Employ
TN Canadian Status - Extend TN Status and Continue Employment
Turn Around Document (PER 17)


U (Return to Top)
UNUM Long term Care Brochure
UNUM Long term Care Enrollment Form
UNUM Long term Care Evidence of Insurability (E of I) Form
UNUM Long term Care Medicare Disclosure
UNUM Long term Care Policy Information
UNUM Long term Care Rates (3 year benefit)
UNUM Long term Care Rates (6 year benefit)
UNUM Long term Care Worksheet

UNUM Long term Care Portability




V (Return to Top)
Vehicle Authorization and Driver Record Verification Form
Visa - H1B Extension - Unit Instructions - PDF or Word
Visa - H1B New Petition - Unit Instructions - PDF or Word
Visa - Extending J1 Exchange Visitor Status - Unit Instructions - PDF or Word
Visa - Obtaining J1 Exchange Visitor Status - Unit Instructions - PDF or Word
Visa - Extending TN Canadian Status - Unit Instructions
Visa - Obtaining TN Canadian Status - Unit Instructions

Vision Enrollment/Cancellation Form



W ( Return to Top)
W-4 Federal Tax Form (Employee Withholding Certificate)
Worker's Compensation Notice of Compliance Poster
Worker's Compensation Incident/Accident Investigation Form
Worker's Compensation Employer Report of Injury/Disease
Worker's Compensation Medical Authorization Release
Worker's Compensation Prescription Drug Benefits



X (Return to Top)


Y (Return to Top)


Z (Return to Top)

Rate This Article:

Have a question or comment about the information on this page?

Innovate . Educate . Improve Lives

The LSU AgCenter and the LSU College of Agriculture

Top