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Human Resources

All UK HR Forms

myUK ESS Guide
Title Form description
Absence Record - (IRIS)
Hiring Officials
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Absenteeism Form

HR Temporary Employment employees are expected to follow attendance and performace guidelines like any regular UK employee. Supervisors should document any issues related to their HR Temporay Employment employees. If a STEPS Temporary employee is absent, please fill this out, keep a copy for your department records and send or fax the completed form to: 

HR Temporary Employment  
103 Scovell Hall, 0064  
Phone: (859) 257­3330  
Fax: (869) 257­7464

Supervisors can contact a Temporary Employment Specialist (TES) for assistance in handling HR Temporary Employment employee performance issues at (859) 257-3330.

End of Orientation Form

Use this form to evaluate new or transferred employees performance after 90 days of employment.

Hiring for KHEAA Work-Study

Please see our KHEAA Work-Study Program site for information about requesting a position to be filled through KWSP (Kentucky Work-Study Program).

Memo of Understanding for Hiring Officials

Hiring officials that are in the process of hiring anyone as it pertains to Policy 17.0: HR Temporary and Student Employment Services should fill out this form.

Salary Recommendation Form (Staff)
Salary Recommendation Form - Campus Instructions
Salary Recommendation Form - Healthcare Instructions
STEPS Employee Request Form
STEPS End of Assignment

Please complete and return this form to the Temporary Employment office by faxing to (859) 257­7464 or send the original via campus mail to:
Temporary  Employment, 103  Scovell Hall, 0064.

STEPS Performance Evaluation

Please fill out this performance evaluation on your STEPS Temporary Employment employee. It is important to us when considering future assignments for each employee. Please complete and return this form to the Temporary Employment office by faxing to 257­7464 or send the original via campus mail to:

Temporary Employment, 103 Scovell Hall, 0064.

Student Employee Request Form

Use this form to submit a request for posting a new Student Employee position.

Supervisor's Checklist - 1st Day
Supervisor's Checklist - 2nd Day through 2 Weeks
Tell Us if you Hired a Student!

If you have hired a Student Employee through UK, we want to know about it! Student Employment at the University of Kentucky is funded in part by a grant, which stipulates that we must collect hiring information. Please help us keep this great service FREE by supplying the following information when you have hired a Student Employment referral. Thank you.

Temporary Disability Leave/Retirement Conversion Form

Use this form to create a new position or redefine the duties of a current position. Once completed all required signatures must be obtained prior to submitting the document to the Compensation Department.

Temporary Employment Evaluation

This form is used by employers to evaluate the performance of a temporary employee.

Retiree Medical Plans
Title Form description
ACH Bank Draft Authorization Form

Fill out and submit this form to enable automatic monthly payment of your UK Retiree Health Insurance premiums by bank draft (ACH).

Retiree Benefits Enrollment Form

Use this form to enroll in Health, Dental, or Vision coverage with UK as a UK Retiree.

Retiree Health Coverage Deferral
Retirement & Financial Security
Title Form description
Allocated Spending Goals

Write a list of everything you would like to do from most important to least important.  When you get extra money from any source, apply it to these goals.  Item one may be new clothes for $100, item two could be a weekend trip away for $300, and item three could be pay off a credit card for $800.  If you receive a $600 tax refund, you could do the first two items and put the remaining $200 towards the credit card debt.

Basic Cash Flow Plan

More than a budget, this will help plan what bills will be paid with each paycheck.

Debt Snowball Form

This form can give you a game plan to pay off your debt. List debts from smallest to largest, pay as much as you can on the smallest and the minimum on the rest.  As one debt is paid off, add the amount you were paying monthly on that debt to the minimum payment on the next debt on the list.

Faculty Phased Retirement Agreement

Use this form for faculty requesting entry into a Phased Retirement process. 

Fidelity 403b Enrollment Form & Beneficiary Designation

Complete this form to make 403(b) retirement savings plan contributions to Fidelity Investments. 

Fidelity 457b Enrollment Form & Beneficiary Designation

Complete this form to enroll in voluntary UK 457(b) retirement savings plan through Fidelity. This form is also used for designating a beneficiary.

Flexible Spending Account Enrollment Form

Use this form to enroll in health and/or dependent care flexible spending accounts. 

Income and Expense worksheet

This worksheet will give you a good basic understanding of what your current income and expenses really are.

Life Insurance and AD&D Enrollment Form

Use this form to enroll in additional levels of life insurance coverage in addition to the University's 1x annual salary coverage. This form also allows you to enroll in separate AD&D (accidental death & dismemberment) insurance, if desired.

Salary Reduction Agreement for Standard (Mandatory) UK 403b Retirement Savings Plan

Complete this form to authorize payroll deductions as contributions to UK's 403(b) retirement savings plan. 

Salary Reduction Agreement for Voluntary UK 403b Retirement Savings Plan

Complete this form to authorize salary deduction for voluntary contribution to your 403(b) retirement savings account. 

Staff Phased Retirement Agreement

This form allows staff of UK to enter a Phased Retirement process.

TIAA-CREF 403b Account Application

Complete this form to enroll in UK 403(b) retirement savings plan through TIAA-CREF. 

UK 403b Voluntary Additional Contribution Enrollment Form (Current Year)

Use this form for additional voluntary contributions, over and above standard 5 percent 403(b) employee contribution.

UK 403b Voluntary Additional Contribution Enrollment Form (Next Year)

UK 403b Voluntary Additional Contribution Enrollment Form (Current Year)

Use this form for additional voluntary contributions, over and above standard 5 percent 403(b) employee contribution.

UK 457b Voluntary Additional Contribution Enrollment Form (Current Year)

Use this form for voluntary contributions to a UK 457(b) retirement savings plan, separate from UK's 403(b) retirement plan.

UK 457b Voluntary Additional Contribution Enrollment Form (Next Year)

Use this form for voluntary contributions to a UK 457(b) retirement savings plan, separate from UK's 403(b) retirement pla

Body Shop Fitness
Title Form description
Body Shop Waiver

This form is required in order for you to become a Body Shop member. Return by mail, email or fax to (859) 323-4700. For questions, please call (859) 257-9355 (WELL).

Cash/Check/Credit Enrollment Form

Fill out this form if you are not a UK employee and are registering for Body Shop. If you are a UK employee you must use the payroll deduction form; however if you are a retiree you may use this form to pay your membership fee with cash, check or credit. Return by mail, email or fax to (859) 323-4700. For questions, please call (859) 257-9355 (WELL).Please note that you may pay online with your card using our online registration system Sign Up For It.

Payroll Deduction Cancellation Form

This form is required in order for you to cancel your Body Shop membership through payroll deduction. Return by mail, email or fax to (859) 323-4700. For questions, please call (859) 257-9355 (WELL).

Payroll Deduction Signup Form

This form is required for any current UK employee who would like to become a Body Shop member. Return by mail, email or fax to (859) 323-4700. For questions, please call (859) 257-9355 (WELL).

Physician Clearance Form

Fill out this form if you would like to participate in Health & Wellness programming and are of one of the following conditions:

  • 45 years of age or older and apparently healthy, 
  • of any age with health factors of concern (e.g., known heart problems). A health history, physical exam, laboratory tests, x-rays, and/or cardiovascular stress test (CVST) are to be performed at the discretion of my physician in the above situations.

Return by mail, email or fax to (859) 323-4700. For questions, please call (859) 257-9355 (WELL).

Wellness
Title Form description
Chair Massage Release Form

This form is required for your participation in Therapeutic Chair Massages offered by UK Health & Wellness. Please fill out and bring the completed form with you the day of your massage. Please arrive 5 minutes before your appointment. 

General Health & Wellness Waiver

This form is required for participation in many Health & Wellness programs and events.

WOW (Health Screening) Consent Form

Please fill out, print and complete this form and the intake form. You will need to bring both with you to your appointment.

WOW (Health Screening) Intake Form

Please fill out, print and complete this form and the consent form. You will need to bring both with you to your appointment.

Employee Medical Plans
Title Form description
COBRA Enrollment form

Use this form to enroll in COBRA insurance coverage, available to UK employees which allows you to continue your group health, dental and vision insurance on an individual basis when you or your dependent(s) become ineligible for University benefits.

Employee Benefits Enrollment Form

Use this form to enroll in UK health benefits, including our health, dental, and vision plans.

Financial Support
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CRISIS Application

Use this form to apply for the CRISIS program, which provides temporary, one-time funds to UK employees in qualifying circumstances.

CRISIS Check Donation form

Use this form to donate to the CRISIS program for fellow UK employees, by donating using a personal check.

CRISIS Payroll Deduction form

Use this form to set up Payroll Deduction for making donations to the CRISIS program for fellow employees in need.

CRISIS Stop Payroll Deduction form

Use this form if you have previously set up a CRISIS donation using automatic payroll deduction, and you wish to stop the payroll deduction.

Employment
Title Form description
Direct Deposit

Direct deposit is mandatory for all UK employees. New Student employees should fill out this direct deposit form, attach a voided check and return to the department of hire. Completed direct deposit forms may also be sent directly to:

UK Payroll
340 Peterson Service Bldg.
0005

Employee Separation Sheet Form

Departments/supervisors should complete this form when an employee leaves employment with the University.

Staff Appointment / Change in Status
HR Home
Title Form description
Drug Free Policy Certification Form

The Federal Drug-Free Workplace Act of 1988 (section 5151) requires that all employees receive a copy of the University's policy, which declares that UK is a drug-free workplace. This policy notification and this certification form insure the University's compliance with the federal law. 

More Great Benefits
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EAHP Application

This form allows UK Employees to apply for the Employer Assisted Housing Program.

EAHP House Listing Form for Sellers

Process for listing a house for sale by owner
1. Ensure that your property is within the UK Area either by reviewing the map.
2. If the property is in the 'UK Area,' complete the form below to request that it be listed on the EAHP website as being for sale.
3. After selling, please contact the EAHP Office by email or phone (859 257-9519, option 1) to request the property be removed from the Property For Sale by Owner page.

EAHP map

This map outlines the area surrounding UK that defines the boundaries of the UK Employee Assisted Housing Program.

EEP (Employee Education Program) Tuition Waiver Form for UK Employees

This fillable form allows UK Employees to enroll in the Employee Education Program (EEP) at UK.

EEP Max Hours Exception Request

This form allows enrolled participants in the Employee Education Program to request a one-time exemption from the semester limit to the number of hours an employee can take.

EEP Tuition Waiver for Murray State

Employees of Murray State who participate in the Employee Education Program must fill out and submit this tuition waiver form.

Family Education Program (FEP) Enrollment Form

As a UK employee, you have the opportunity to enroll a family member in the Family Education Program through UK.

Flexible Spending Claim Form
Elder Care
Title Form description
Elder Care Lunch & Learn Registration

UK Elder Care is pleased to present the 2014 Lunch & Learn Series. Bring your lunch and learn about important topics. Each free session requires preregistration and is open to UK faculty, staff, retirees, spouses, and sponsored dependents. Space is limited. Use the online form to sign up

Request Resources for Elder Care Caregiver

Thank you for your interest in receiving Caregiving Resources via the UK Elder Care Office.  Please complete the form.

Employee Relations
Title Form description
Employee Grievance Form
Organization Unit Change Form

Use this form to create new organizational units and to change existing information concerning organizational units in SAP

Position Reporting Change Form

Use this form to change the position reporting information in SAP.

Temporary Disability Leave/Vacation Leave Conversion Form

This form is used by full-time staff to convert temporary disability leave to additional vacation leave.

Unemployment
Title Form description
Exit Checklist - Campus

Contact (859) 257-8758 for more information.

Exit Interview Survey

The exit interview is an opportunity to obtain valuable information about perceptions, frustrations and areas in need of improvement. The Exit Interview Survey is designed to gather information in a consistent non-threatening manner. Although written in survey format, each department is encouraged to identify a neutral third party to meet one on one with the employee and gather information orally. The exit interview is voluntary but strongly encouraged.

Benefits
Title Form description
Express Scripts Manual Claim Form for Employees and Retirees Under Age 65

Under some circumstances it may be necessary to manually file a prescription claim.  For example if you are out of town and cannot locate your Express-Scripts ID card, it may be necessary to pay for the prescription and manually file for reimbursement once you return. 

Please note claims must be filed within twelve (12) months of receiving a prescription.

Express Scripts Manual Claim Form for Retirees Age 65 and Over (Medicare Carveout Plan)

Under some circumstances it may be necessary to manually file a prescription claim.  For example if you are out of town and cannot locate your Express-Scripts ID card, it may be necessary to pay for the prescription and manually file for reimbursement once you return. 

Please note claims must be filed within twelve (12) months of receiving a prescription.

Name Change Form

Use this form for any name change(s). Once completed, the form must be forwarded to Employee Records and Benefits. To change home and work addresses, go to myUK at https://myuk.uky.edu and update using the Employee Self Service (ESS) portal.

Compensation
Title Form description
Flex Leave Form

Use this form when an employee is being placed in an approved flex leave position. This form should be forwarded to the Compensation Department along with the PAR prior to the employee being placed on flex leave.

Independent Contractor: Worker Status Evaluation Form

This form must be completed by department administrators prior to retaining any individual to provide services and submitted to HR as explained in BPM E-7-3.

Internal Overload Form

Form to be completed for approval of assignment outside exempt employee's main department/work assignment.

Job Analysis Questionnaire (JAQ)
Workplace Flexibility
Title Form description
FlexWork Request Form

Use this form to submit an online request for flexible work schedule. A copy of the submitted form goes to you, your supervisor, and the Director of WorkLife at UK. Together you will work out the best flexible workplace arrangement.

Summer Hours Application Form
Family Medical Leave
Title Form description
FML Notification Memo
Request for Family and Medical Leave

UK HealthCare employees should submit paper copies of the form to UK HealthCare FMLA administrator at whitney.cunningham@uky.edu or fax to (859) 257-2010.

Campus (non-UK HealthCare) employees may submit to their department supervisor or designee.

Request for Military Family Leave Form

Request for Family and Medical Leave - Serious injury or illness of current servicemember for Military Family Leave

Request for Qualifying Exigency for Military Family Leave

Request for Family and Medical Leave - Qualifying Exigency for Military Family Leave

Request for Veteran for Military Caregiver Leave
Resources for Parents
Title Form description
Grogan's Breast Pump Rental Form

Use this form to apply for free rental of a breastpump from Grogan's Medical Supply, as part of UK's support of lactation in the workplace.

Student Employment
Title Form description
KHEAA Work-Study Application

Kentucky Higher Education Assistance Authority (KHEAA) Work-Study Program Student Application

Give yourself an edge in finding and keeping a career related position. If you already have a job please let us know. We may be able to reimburse your employer which could provide them with more money to keep you employed!

Tell Us When You're Hired

Student Employment at the University of Kentucky is funded in part by a grant, which stipulates that we must collect hiring information. Please help us keep this great service FREE by supplying the information when you are hired.

Counseling
Title Form description
Request a Mental Health Kit

This kit includes helpful information and resources about common conditions and how to support a friend or loved one. To request your FREE Kit, simply complete the form. If you wish to schedule an appointment with Work+Life Connections, please call 859-218-0461.

Records
Title Form description
Salary Release Authorization Form

This form should be signed and submitted along with any requests for records from the Employee Records department. The records cannot be released until this form has been submitted.

Shared Leave Pool
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Shared Leave Pool Online Donation Form

Regular UK staff employees with a 0.5 FTE or greater who have successfully completed New Employee Orientation period may donate up to ten (10) vacation leave days per fiscal year to the Shared Leave Pool.

Staff Shared Leave Application

This form allows UK Staff to apply for use of the Staff Shared Leave Pool allocation.

Healthtrac Rewards
Title Form description
Step-By-Step Guide: UK Healthtrac Rewards (PDF)

This PDF offers a walkthrough with screen shots showing how to register and login to Healthtrac Rewards system — in addition to a guide on how to navigate the program's features and earn rewards.

Temporary Employment
Title Form description
STEPS Timesheet

Fill out this form using the instructions on the STEPS Timesheet Guide page

SUBMISSION INSTRUCTIONS

Unless handled by the department, it is the temporary employee’s responsibility to submit a copy of  his/her signed timesheet reporting all hours worked to the Temporary Employment office at 103  Scovell Hall, or fax it to 257-7464, or email a PDF file to TempEmpTimesheets@uky.edu by 12:00 p.m. on the dates listed below. Temporary Employees are not permitted to deliver original timesheets. Original timesheets need to be submitted by the supervisor to the Temporary Employment Office via campus mail or personal delivery by payday Friday. 

 

Temporary Employees - Address Change
Temporary Employment Timesheet

This form is used by temporary employees to record their work hours for a given pay period.

Career Development
Title Form description
UK Career Development Contact Form

UK Employees: Contact us to get started on the path of Career Development.

UK Career Development Registration Form

This intake form will provide the Career Development office with the preliminary information they need to better assist you for your Career Develompent appointment.