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Forms/Documents


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 Forms/Documents

The following resources are intended for employees of Northern Illinois University. Please refer to the categories to obtain the proper documentation.


PeopleSoft Forms
Title Type
 HRS Required Forms Matrix
 Last Revised: 2/28/2003
 Personal Data/Name Address Form
 Last Revised: 03/26/2007
 Hourly Time Sheet and Benefit Usage Report
 Last Revised: 03/26/2007
 Salaried Employee Benefit Usage Form
 Last Revised: 03/26/2007
 Additional Pay Form
 Last Revised: 03/26/2007
 Personnel Action Form
 Last Revised: 03/26/2007
 Position Request Form
 Last Revised: 1/10/2008

New Hire / Employment Forms
Title Type
Grad Asst Renewal Application
 Posted On : 5/2/2006

  Form W-4 (2008)
 Last Revised: 1/3/2008
 I9 Form (Employment Eligibility Verification)
 Last Revised: 07/01/2008
Offer Letter Template for New Graduate Assistants
 Last Revised: 6/16/2004
 Contract Templates for Faculty/SPS
 Last Revised: 9/30/2004		 Internet Explorer Icon
 Affirmative Action Recruitment Record - Part 1
 Last Revised: No revision date
  Affirmative Action Recruitment Record - Part 2
 Last Revised: No revision date
 AffirmativE Action Hiring Record (Civil Service)
 Last Revised: 2/25/2004 		Microsoft Excel IconAdobe Acrobat Icon
  Foreign National Information Form
 Last Revised: 7/26/2004		 Microsoft Excel IconAdobe Acrobat Icon
  Independent Contractor Certified Work Statement
 Last Revised: 08/06/2007 		Microsoft Excel Icon
  Independent Contractor Questionnaire
 Last Revised: 10/23/2002		 Microsoft Word Icon
  Establishing Employment Relationships - Independent Contractor or Employee
 Last Revised: 10/23/2002		 Microsoft Word Icon
  Independent Contractor Memorandum
 Last Revised: 10/23/2002		 Microsoft Word Icon
  9 over 12 Policy & Form
 Last Revised: 7/23/2002		 Microsoft Word Icon
  Civil Service Employment Information 1 of 2
 Last Revised: 6/2/2003		 Adobe Acrobat Icon
  Civil Service Employment Application 2 of 2
 Last Revised: 6/5/2003		 Adobe Acrobat Icon
  Request for Waiver of External Search
 Last Revised: 11/05/2003		 Adobe Acrobat IconMicrosoft Word Icon
  Principal Administrative Position Exemption
      Request Form
 Last Revised: 10/29/2003		 Microsoft Word Icon
  Selective Service Form - Grad Asst
 Last Revised: 10/3/2002		 Microsoft Word Icon

Graduate Assistant Application
 Last Revised: 3/31/2004 NEW

 Adobe Acrobat Icon
Graduate Assistant Employment Applicant Evaluation
 Last Revised: 2/10/2004 		Adobe Acrobat IconMicrosoft Word Icon
  Job Not Covered By Social Security - SSA FORM 1945
 Last Revised: 12/22/2004 		Internet Explorer Icon

Ethics Act Forms
Title Type
2006 Ethics Act Orientation
 Last Revised: 11/12/2006 		Adobe Acrobat Icon

FMLA Forms
Title Type
Benefit Usage form - employee's request
 Last Revised: 11/16/05		 Adobe Acrobat Icon
Employee Application FMLA, Family, VESSA, SURS, Illness
 Last Revised: 11/16/05		 Adobe Acrobat Icon
Medical Certification - Medical Leave
 Last Revised: 11/16/05		 Adobe Acrobat Icon
Return to work form for Doctor-purple sheet
 Last Revised: 11/16/05		 Adobe Acrobat Icon

 FMLA FIL handout
Last Revised: 2/1/2008
 Confidentiality notification
Last Revised: 2/1/2008		 Microsoft Word Icon

 Sworn Statement
Last Revised: 11/16/2005

 Microsoft Word Icon
Employee Changes
Title Type
 Selective Service Form
 Last Revised: 10/3/2002		 Microsoft Word Icon
 Direct Deposit Authorization Change
 Last Revised: 10/22/2002		 Adobe Acrobat Icon
 Savings Bond Authorization
 Last Revised: No revision date 		Adobe Acrobat Icon
 Exit Checklist
 Last Revised: No revision date
 Start/Stop Payroll Deduction Authorization
 Last Revised: 3/31/2003		 Adobe Acrobat Icon
 Civil Service Employment Register Request Form
 Last Revised: 5/9/2003		 Microsoft Excel Icon
 Civil Service Request To Test Form
 Last Revised: 6/23/2003		 Microsoft Excel Icon

Employee Performance
Title Type
 Student Evaluation Form
 Last Revised: No revision date

Authorization & Security
Title Type
 Adult Academic Support Service Volunteer and Personal
     Assumption of Risk Agreement
Last Revised: 2/18/2008

 Instructional Volunteer Agreement for Adjunct Faculty
Last Revised: 3/5/2008

 Microsoft Word Icon
 Volunteer Services Agreements - Non Instructional
Last Revised: 10/22/2003		 Microsoft Word Icon
Authorization for Release of Information
 Last Revised: 06/25/2008
 Student Academic Probation Work Permit
 Last Revised: No revision date
 Excess Hours Permit
 Last Revised: No revision date
  Department Information Form
 Last Revised: No revision date 		Microsoft Excel Icon
 Authorization to Travel Form
 Last Revised: 1/30/2004		 Internet Explorer Icon
  Request for Leave of Absence
 Last Revised: 3/29/2004 		Microsoft Word IconAdobe Acrobat Icon
 Request for Sabbatical Leave
 Last Revised: 8/4/2008 		Microsoft Word IconAdobe Acrobat Icon
  Notice to Employees with Employer-Provided Vehicles
 Last Revised: 10/5/2007 		Microsoft Excel IconAdobe Acrobat Icon


Benefits Forms
Title Type
 2007 Benefits Billing Frequently Asked Questions
 Posted On : 5/3/2007 		Adobe Acrobat Icon
 Family Military Leave Form
 Posted On : 9/27/2005		 Adobe Acrobat Icon
 CompBenefits Dental Claim Form
 This document is not maintained by HRS. 		Adobe Acrobat Icon
 CMS Health Claim Form for Quality Care/Cigna
 Last Revised: 11/25/2003		 Adobe Acrobat Icon
 CMS Group Life Insurance Beneficiary Form
     (Minnesota Life)
 Last Revised: No revision date		 Adobe Acrobat Icon
 CMS Mental Health/Substance Abuse Claim Form
     (Magellan)
 Last Revised: 7/7/2005 		Adobe Acrobat Icon
  CMS Dependent Coverage Certification Form
 Last Revised: 2/12/05 		Adobe Acrobat Icon
  CMS Dependent Care Assistance Plan (DCAP)
      Enrollment Form
 Last Revised: 8/14/2006 		Adobe Acrobat Icon
  CMS Medical Care Assistance Plan (MCAP)
      Enrollment Form
 Last Revised: 8/14/2006 		Adobe Acrobat Icon
  Prudential Long Term Disability Enrollment Form
 Last Revised: 10/23/2003		 Adobe Acrobat Icon
  Prudential Long Term Disability
      Short Form Health Statement
 Last Revised: 10/23/2003		 Adobe Acrobat Icon
  CMS Group Insurance Change Form
      (Non-Benefit Choice Change)
 Last Revised: 3/26/2008 		Adobe Acrobat Icon
  CMS Qualifying Event Change Form
 Last Revised: 11/25/2003		 Adobe Acrobat Icon

  Minnesota Life - Statement Of Health
 Last Revised: Revised by CMS

 Adobe Acrobat Icon
Caremark Prescription Mail Order Service Form
 Last Revised: 7/21/2004 		Adobe Acrobat Icon

  FSA Reimbursement Request Form (FY 04)
 Last Revised: Revised by CMS

 Adobe Acrobat Icon
OPT Out & OPT In Election Certificate
 Last Revised: 2/12/05		 Adobe Acrobat Icon
SICK Bank Form (Regular Employees)
 Last Revised: 5/2/05		 Adobe Acrobat Icon
   

 

Tuition Waiver Forms
Title Type
 CS/SPS Faculty Tuition Waiver Application
 Last Revised: 1/16/2008

Adobe Acrobat Icon

 Waiver for Survivors of Deceased Employees
 Last Revised: 8/24/2004

 Adobe Acrobat Icon
 Dependent Tuition Waiver
 Last Revised: 8/24/2004		 Adobe Acrobat Icon

 Interinstitutional Waiver of Tuition
 Last Revised: 8/24/2004

 Adobe Acrobat Icon

 

Workers' Compensation Forms
Title Type
 CMS Workers' Compensation Packet
 Last Revised: 1/19/2008		 Internet Explorer Icon
 CMS Worker's Compensation Employee's Notice Of Injury
 Last Revised: 03/15/2004		 Internet Explorer Icon
 CMS Workers' Compensation Claimant Information Release
 Last Revised: 03/15/2004		 Internet Explorer Icon
 CMS Workers' Compensation Supervisor Report of Injury
 Last Revised: 03/15/2004		 Internet Explorer Icon
 CMS Workers' Compensation Demands of the Job
 Last Revised: 03/15/2004		 Internet Explorer Icon
  CMS Workers' Compensation Witness Report
 Last Revised: 03/15/2004 		Internet Explorer Icon

 

Deferred Compensation
Title Type
2008 403(b) and 457(b) Brochure.pdf
 Last Revised: 2/18/2008		 Adobe Acrobat Icon
403(b) and 457(b) Tax-Deferred Compensation
      Programs Memo
 Last Revised: 2/18/2008		 Adobe Acrobat Icon
 Salary Reduction Agreement "403(b)"
 Last Revised: 8/9/2006 		Microsoft Excel Icon
 State Employees' Deferred Compensation
      Plan Enrollment  Form (457)
 Last Revised:5/22/2008		 Internet Explorer Icon
 State Employees' Deferred Compensation Plan
     Beneficiary Election Form
 Last Revised: 1/7/2003		 Internet Explorer Icon
 State Employees' Deferred Compensation
      Plan Change Form
      Last Revised: 1/7/2003		 Internet Explorer Icon


Instructions

To view documents, click on the document's icon type from the file listing.

To save documents to your Hard Drive, Right Click on the file name and select Save Target As... Select a location to save the document in and click on Save.
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