Skip to the content

Kansas State University

Downloads for Forms

Download the free Microsoft Office Viewers or Converters

Adobe Acrobat Reader (shareware) must be installed on your computer to print or complete the PDF forms. The complete Adobe Acrobat software (not shareware) is required to save a completed PDF form.

Rich Text Format (RTF) forms may be used by any word processor (Word, Works, WordPerfect, etc.) and do not require special software.

Form directions and/or additional information are provided in the Instructions or Information Column or within the form.

Technical Support for Forms:
Kathy Kugle (785) 532-1885
or email kkugle@ksu.edu

Forms

Division of Human Resources
Kansas State University
103 Edwards Hall
Manhattan, KS 66506-4801
785-532-6277
785-532-6095 (fax)
8 a.m. - 5 p.m. (CST)
Contact HR

Classified Staff Forms

Refer to Classified Transactions for instructions on personnel transactions. Refer to the summary of benefits for classified staff for additional information on benefits entitlements.

  • A |
  •  B |
  •  C |
  •  D |
  •  E |
  •  F |
  •  H |
  •  I |
  •  L |
  •  M |
  •  N |
  •  O |
  •  P |
  •  R |
  •  S |
  •  T |
  •  U |
  •  W
Alphabetical List of Classified Staff Forms
FORMS by NameDatedInstructions
or Information		 Versions
Above Step Request (PER-3) 10/2003 PPM 4450.30 RTF Word PDF  
Accident/Injury Report (PER-17) (Workers' Compensation) 07/2009 PPM 4820.100 RTF Word PDF  
Administrative Leave Reporting 6/2003 PPM 4860.20 RTF Word PDF 
Advance Leave Agreement for Classified Employees PER-60 10/2009   RTF Word PDF  
Affirmative Action Classified Selection Report (PER-10)   Affirmative Action-Recruitment RTF Word PDF 
Agency Payroll Deduction Authorization 5/2007 Agency Payroll Deductions RTF Word PDF 
Agreement of Understanding for Overlapping Appointment (PER-28) 10/2004 Military Service Policy RTF Word PDF 
Agreement for Limited Term Appointment (PER-43) 10/2004 PPM 4460.40 RTF Word PDF 
Agreement for Reimbursement of Moving Expenses(DA-22) 11/1998 Moving Expenses RTF Word PDF 
Agreement for School Employee Appointment (PER-21) 3/2004   RTF Word PDF 
Annual Review of Classified Position Descriptions (PER-26) 07/2008 PPM 4210 RTF Word PDF 
Application for President's Scholarship (PER-32A) 01/2007 PPM 4870.40 RTF Word PDF  
Application for Tuition Assistance 2009/2010       PDF 
Appointment Form (PER-38) 09/2008 Unclassified
Classified		 RTF Word PDF 
Authorization to Release Information 10/2004 PPM 4010 RTF Word PDF 
Background Check Request Form (PER-59)10/2008Background ChecksRTF WordPDF 
Beneficiary Designation (KPERS-7/99) 07/2006 PPM 4820.60    PDF 
Change or Separation Form (PER-39) 12/2006 Unclassified
Classified
Grad Student		 RTF Word PDF 
K-State Classified Award of Excellence Nomination Form   Guidelines RTF Word PDF  
Conflict of Interest Form   Conflict of Interest Policy      Online
Departmental Employee of the Year Award & Recognition Program Monetary Award Payment Form (PER-7) 11/2009 Guidelines RTF Word PDF  
Designation of Beneficiary (KPERS-7/99) 07/2006 PPM 4820.60    PDF 
Direct Deposit of Employee Pay (PER-58) 12/2007 Instructions
Information		 RTF Word PDF 
Educational Authorization Form (PER-25) 5/1998 PPM 4870.20 RTF Word PDF 
Employee Conference Form  PPM 4020    PDF  
Employee Performance Review System-
Employee Performance Review (PER-47)		 03/2006 Instructions
Presentation in PPT
Supervisor's Guide - Action Steps (PDF)
Training		 RTF Word PDF 
Employee Performance Review System-
Employee's Annual Report of Activities (PER-48)		 09/2004 Instructions
Presentation in PPT
Supervisor's Guide - Action Steps (PDF)
Training		 RTF Word PDF 
Employee Peformance Review System-
Professional Development and Growth Plan (PER-49)		 09/2004 Instructions
Presentation in PPT
Supervisor's Guide - Action Steps (PDF)
Training		 RTF Word PDF 
Employee Performance Review System-
Performance on Goals and Projects (PER-50)		 09/2004 Instructions
Presentation in PPT
Supervisor's Guide - Action Steps (PDF)
Training		 RTF Word PDF 
Employee Separation Checklist (PER-24) 02/2008 Classified Separations
Unclassified Separations
PPM 4950		 RTF Word PDF 
Employment Application (Online)   Classified Employment       
Employment Eligibility Verification (I-9) 08/2009 Instructions    PDF 
Exit Interview for Classified Employees (PER-16) 6/2003 PPM 4950 RTF Word PDF 
Flexible Spending Claim Form 2010 Flexible Spending Accounts     PDF
Flexible Spending Account Direct Deposit/E-Mail Notification Form   Flexible Spending Accounts   Word   
FMLA Certification of Health Care Provider for Employee's Serious Health Condition   FMLA Dept. of Labor     PDF 
FMLA Certification of Health Care Provider for Family Member's Serious Health Condition   FMLA Dept. of Labor     PDF 
FMLA Notice of Eligibility and Rights & Responsibilities   FMLA Dept. of Labor     PDF 
FMLA Designation Notice   FMLA Dept. of Labor     PDF 
FMLA Certification of Qualifying Exigency For Military Family Leave   FMLA Dept. of Labor     PDF 
FMLA Certification for Serious Injury or Illness of Covered Servicemember -- for Military Family Leave   FMLA Dept. of Labor     PDF 
KSU Foreign National Tax Information Form (PER-15) 07/2007 Visa Classifications RTF Word PDF 
Health Care Selection Form 06/2003 Health Insurance     PDF  
Health Insurance Affidavit of Common Law Marriage and Request for Enrollment of Common Law Spouse 08/2009 Health Insurance     PDF  
Health Insurance Application for Coverage of Handicapped Dependent Child 02/2008 Health Insurance     PDF  
Health Insurance Communication Form 08/2009 Health Insurance     PDF 
Health Insurance Dependent Grandchild Affidavit 07/2009 Health Insurance     PDF  
HIPAA- Authorization Form for Release of Medical Information 03/2008 Health Insurance     PDF  
Health Savings Account Enrollment & Change Form 08/2009 Health Insurance     PDF  
HealthyKIDS Application   Information(pdf)      Online
Holiday Emergency Overtime Reporting 6/2003 PPM 4450.70 RTF Word PDF 
HRIS/PeopleSoft Access Form   Instructions (pdf)
HRIS Roles		 RTF Word PDF 
HRIS Problem Investigation Request Fax Form 11/1996   RTF Word PDF 
Initial Screening of Candidates Prior to Interview (AA-28)   Instructions RTF Word PDF Excel
Intellectual Property Agreement   Information RTF Word PDF  
Investment Agreement - Voluntary Retirement Plan (PER-19) 11/2008 PPM 4810.80 RTF Word PDF  
Kansas Employee's Withholding Allowance Certificate (K-4) 09/2007 Information     PDF  
Learning Quest Direct Investment Form Information    PDF 
Learning Quest Payroll Deduction Change Form  Information    PDF 
Leave Balance Correction Sheet (PER-9) 5/2001 Information RTF Word PDF 
Leave Record 05/2009
for FY 2010		 Instructions RTF Word PDF Excel
Leave Request-Hourly (Non-Exempt) Employees   Instructions      Online
Leave Request-Salaried (Exempt) Faculty and Staff   Instructions      Online
Life Insurance Beneficiary Designation Form (TEA) 07/2001 Included
TEA Life Insurance		     PDF  
Life Insurance Enrollment Form (TEA)   TEA Life Insurance     PDF 
Life Insurance Request to Change or Cancel Insurance Policy Form (TEA)   TEA Life Insurance     PDF  
Life Insurance Statement of Health (TEA)   TEA Life Insurance    PDF 
Mileage Reimbursement Form (Workers' Compensation)   Information RTF Word PDF  
New Course Data Sheet 12/2008 Instructions (PDF) RTF Word PDF 
New Employee Orientation Forms Checklist 11/2001 PPM 4070 RTF Word PDF  
Non-Resident Alien Forms   Non-Resident Alien Employment       
Notification of Retirement (PER-37) 6/2009 PPM 4810 RTF Word PDF  
Optional Group Life Enrollment Form   Optional Life     PDF 
Optional Group Life Reduction/Cancellation Form 09/2003 Optional Life     PDF 
Orientation Checklist 12/2007 PPM 4070 RTF Word PDF 
Orientation Forms Checklist 11/2001 PPM 4070 RTF Word PDF  
Overtime Compensation Agreement for Non-Exempt Employees (PER-34) 02/2007 PPM 4220.70 RTF Word PDF  
Paycheck Stop Payment Request (DA-6P) 05/2006 Information   PDF Excel
Payroll Transfer Form (PER-44)04/2009Instructions   PDFExcel
Performance Management Process Form NEWPerformance Management Process
Instructions		 RTF Word PDF  
Position Data Sheet (PER-36) 02/2007 Unclassified
Classified		 RTF Word PDF  
Position Description (Classified) (DA 281-2 Special) 1/1999 PPM 4210
Position Descriptions Checklist		 RTF Word PDF  
Prescription Claim Form   Prescription Drug Program     PDF  
Prescription Drug Advance Purchase Certificate 03/2008 Advance Purchase Policy(pdf)     PDF  
President's Scholarship Application (PER-32A) 01/2007 PPM 4870.40 RTF Word PDF  
Request for Certified Names (PER-5) 07/2003 Department Recruitment Procedures RTF Word PDF  
Retirement Notification (PER-37) 6/2009 PPM 4810 RTF Word PDF  
Retirement Plan Investment Agreement - Voluntary(PER-19) 11/2008 PPM 4810.80 RTF Word PDF  
Savings Bond Payroll Savings Authorization (PER-14) 01/2007 U.S. Savings Bonds RTF Word PDF  
Shared Leave Donation Form 8/2001 Classified PPM 4860.140
Unclassified PPM 4865.140		 RTF Word PDF  
Shared Leave Request Form 10/2007 Classified PPM 4860.140
Unclassified PPM 4865.140		 RTF Word PDF  
Substance Abuse Policy Affirmation Form 5/2007 Information RTF Word PDF  
Tax Clearance Information Form for Candidates and New Hires (DA-2004a) 05/2004 Information     PDF  
TEA Life Beneficiary Designation Form 07/2001 Included
TEA Life Insurance		     PDF  
TEA Life Insurance Enrollment Form   TEA Life Insurance     PDF  
TEA Life Insurance Request to Change or Cancel Insurance Policy Form   TEA Life Insurance     PDF  
TEA Life Insurance Statement of Health   TEA Life Insurance     PDF  
Tuition Assistance Application 2009/2010       PDF 
U.S. Savings Bond Payroll Savings Authorization (PER-14) 01/2007 U.S. Savings Bond RTF Word PDF  
Workers' Compensation Accident/Injury Report (PER-17) 07/2009 PPM 4820.100 RTF Word PDF  
Workers' Compensation Mileage Reimbursement Form   Information RTF Word PDF  
W-4 Employee's Withholding Allowance Certificate
OR Update online in Employee Self Service		 2009 Included
Information		     PDF 
Withholding form
Kansas Employee's Withholding Allowance Certificate (K-4)		 09/2007 Information     PDF  
W-5 Earned Income Credit 2009 Included
Information		    PDF 
W-9 Request for Taxpayer Identification Number and Certification 10/2007 Included    PDF