Human Resources/Payroll Forms

Overview:

These are internal forms for the Human Resources/Payroll Department. Many Human Resources and Payroll forms are routed through Adobe Sign for processing. This allows employees to complete, sign, and submit forms electronically. Click the form’s name below to initiate the Adobe Sign process. In order to submit the completed form after it has been signed, you must verify your identity by clicking on the link sent to your email address.
 
Form Name Form Description What to do with form
ADA Medical Inquiry Form   Have your medical provider complete the form and submit to EEO@MATSUK12.US .
ADA Request for Accommodations Complete this form to request accommodations under the American Disability Act (ADA). Complete the form and electronically sign through Adobe Sign.
Additional Time Worked  Additional time worked by CEA employees that was not entered in Time & Attendance by the Payroll deadline should be submitted using this form.  Submit the completed form to the Payroll Department.
Admin Retirement Contribution Enrollment   Complete the form and electronically sign through Adobe Sign.
Admin Secretary Payroll Calendar  Payroll deadlines and important dates. For use by Admin. Secretaries.
Adult Worker Application    
Adult Worker Pay Calculation  This form should be completed when paying adult workers with student activity funds. Submit the completed form to the Human Resources Department.
Amended Absences  Absences entered in Absence Management that were not entered/corrected by the Payroll deadline should be submitted using this form. Submit the completed form to the Payroll Department.
Appreciation Payment    
Badge Matrix (Also in Access Requests)    
Cell Phone Allowance    
Cell Phone Request    
Certified Adult Worker Application    
Co-Curricular Application    
Co-Curricular Reactivation    
Co-Curricular Stipend Request    
Column Move/Credit Count This Service Request is for MSEA employees to request a change in contract salary on the basis of additional credits earned OR to request that HR provide a course unit report (credit count).

1) Request Official Transcripts

2) Fill out Request form and submit. Additional instructions and deadlines are on the Service Request page.
Dependent Day Care Reimbursement American Fidelity Dependent Day Care reimbursement request.  Submit the completed form to American Fidelity
Employee Submitted Expense Adjustment This form is for notifying the Payroll Department that an expense claim was incorrectly submitted. Submit the completed form to the Payroll Department
Entering Time Worked in Time and Attendance    
FMLA Application - Bonding    
FMLA Application - Employee's Serious Health Condition    
FMLA Application - Family Member's Serious Health Condition    
Health Insurance  - Premera Name/Dependent Change This form should be used to add or remove dependents from an employees' health insurance plan (Premera). Complete the form and electronically sign through Adobe Sign.
Health Insurance Pre-Tax Election  You can elect or waive the option to have health insurance premiums withheld on a pre-tax basis by completing this form. Complete the form and electronically sign through Adobe Sign.
I-9    
MLMA Education/Certificate Stipend Request Form  

Complete the form and electronically sign through Adobe Sign.
MSBSD Health Savings Account Payroll Deduction   Complete the form and electronically sign through Adobe Sign.
MSBSD UA College Savings Plan Payroll Deduction  Use this MSBSD form to initiate or modify payroll deduction contributions to the University of Alaska College Savings Plan. Submit the completed form to the Payroll Department.
MSEA 1% Retirement Contribution Enrollment   Complete the form and electronically sign through Adobe Sign.
Pay Option Form    
Physical Exam Form    
PTO Leave Cash In Form MSEA, MSPA, MLMA, and EXEC employees should use this form to request to cash-in paid time off leave. Complete the form and electronically sign through Adobe Sign.
Religious Accommodations Request Complete this form to request accommodations for religious beliefs or practices. Complete the form and electronically sign through Adobe Sign.
Return to Work Authorization    
Reviewing and Approving Timesheets    
Section 125 Flexible Benefit Plan Expense Reimbursement Voucher  X X
Sick Leave Bank - Certified Application  This is the sick leave bank application for MSEA and MSPA employees that are members of the bank. Submit the completed application to the Sick Leave Bank Chairperson
Sick Leave Bank - Certified Special Collections Application  This is the special collections sick leave bank application for MSEA and MSPA employees that are members of the bank Submit the completed application to the Sick Leave Bank Chairperson.
Sick Leave Bank - Classified Application This is the sick leave bank application for CEA employees that are members of the bank. Submit the completed application to the Sick Leave Bank at matsuceaslb@gmail.com
Sick Leave Bank - Classified Special Collections Applications  This is the special collections sick leave bank application for CEA employees that are members of the bank Submit the completed application to the Sick Leave Bank at matsuceaslb@gmail.com
Sick Leave Bank Notification - Certified Certified employees can elect to opt in or opt out of the Sick Leave Bank using this form. Submit the completed form to the Payroll Department
Sick Leave Bank Notification - Classified  CEA employees can elect to opt in or opt out of the Sick Leave Bank using this form. Submit the completed form to the Payroll Department
Site Exclusion Form    
Special Pay Form    
Student Worker Pay Calculation This form should be completed when paying student workers with student activity funds. Submit the completed form to the Human Resources Department
Substitute-Temporary Worker Time Sheet  This is an optional timesheet that schools and departments may utilize for internally reporting substitute/temporary worker time worked Submit the completed form to the Payroll Department.
Summer Pay Election Form CEA employees can elect to have money held back on each paycheck and paid in one lump sum on their last paycheck. Submit the completed form to the Payroll Department.
Supplemental Retirement Leave Cash In   Complete the form and electronically sign through Adobe Sign.
UA College Savings Plan Employee Payroll Deduction  Use this form to initiate or change existing allocations of payroll deduction contributions to the University of Alaska College Savings Plan. Submit the completed form to the Payroll Department
Verification of Service    
Volunteer Application    
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