HR forms




Purpose - description

A-4 Instructions. An electronic A-4 is available through My ASU日本一本道a不卡免费 > Employee Info > My Employment > Payroll Tab > Tax Information > A‐4 Tax Information.

Applicant List日本一本道a不卡免费- for resumes sent directly to departments

Use to track resumes received from applicants replying to a posted position.

ASU ID number change request

Employees Only - Use to request a change to an ASU ID number that is not a social security number.


Background checks


Used to perform a background verification for a new employee. for more info.


日本一本道a不卡免费Used to perform a background verification for a new employee. for more info


Benefits program

日本一本道a不卡免费Benefits enrollment

Important: See the retirement section below.

Administered by the Arizona Department of Administration, Benefits Services Division.
Family adoption and fertility benefits

Flexible Spending Accounts

  • - University employees must use the Arizona Board of Regents FSA claim form.
  • - Sign up for a direct deposit and get email or text notices of account activity.
  • - For healthcare FSA participants.

Walgreens mail service registration and prescription order form for State of Arizona and universities.

 - For Physicians

日本一本道a不卡免费The physician should use this form to order a 90-day prescription from Walgreens mail service.

Prescription Reimbursement

Use to request a reimbursement from MedImpact when you have paid out-of-pocket for a prescription.

Use this form to request a continuation of medical care with a provider who is not in your chosen network.

Unum Beneficiary Designation For Unum short-term disability participants to designate a beneficiary for the Unum Life/AD&D insurance policy.


Claim forms

Use to submit a claim to Delta Dental.

Medical Claim

Used to claim out-of-network vision benefits.


Name Purpose - Description

Data Management

Departments should use this form to request new department codes or modifications to existing codes. Fill out at least two weeks before the effective date of the change.

Direct Deposit

Used to establish or change direct deposit of pay.

Disability Self-identification

日本一本道a不卡免费Employee use to voluntarily self-identify as having a disability.

Emergency Hire

Used to fill an open position that needs an immediate hire, has been replaced by the Waiver of Recruitment form.


Employee Assistance Office - New Client Paperwork

Download and fill out these forms before your first appointment with EAO ASU Employee or Family-Spouse-Partner.

Voluntary survey for applicants who apply for faculty and other academic positions.

Exit Interview Questionnaire

Optional for employees leaving ASU.

Faculty and Academic Professional Search Plan

日本一本道a不卡免费Use when beginning a search for a faculty member or academic professional.

FICA Refund Request

Use this form when an employee requests a prior year refund on FICA OASDI and MEDICARE.

Flexible Employment
Conversion Application

Use this form to volunteer to reduce your time worked by one to six pay periods a year.

Focused Recruitment

日本一本道a不卡免费This form has been replaced by the Waiver of Recruitment.

Paper forms are no longer accepted. Please use eHire which can be accessed through .


Name Purpose - Description

I -9

  •   form for in-person verification of employment eligibility.
  • I-9 notary instructions for new employees located out of state.

Independent contractor checklist

日本一本道a不卡免费Use this form for review and approval of Independent Contractors before a performance of services begins.

Information for exiting-employees Overview of information for employees leaving ASU.

Leaves of absence for employees

日本一本道a不卡免费One of several forms you need to submit to request an FMLA medical leave.

日本一本道a不卡免费Compassionate transfer of leave

日本一本道a不卡免费One of several forms you need to submit to request a leave for birth/placement/bonding.

  • Request leave for birth/placement/bonding or medical or personal reasons.
  • Employee Military Leave - Request leave for military training/active duty.

Release to return to work

日本一本道a不卡免费Health care provider certification.

Request for time off

Hourly employee sick-vacation-compensatory-bereavement/jury request.

Leaves management for departments

FMLA tracking spreadsheet Record approved FMLA time for intermittent and continuous leaves of absence.

日本一本道a不卡免费Leave of absence or hold

Name change - ASU For employees to use to request a name change - instructions.
For employees who are ASRS members to request a name and address change.
Note: Submit the completed form to ASRS, not ASU.

New hire packet

HR forms and payroll information.
Important: Do not print two-sided.日本一本道a不卡免费 These forms must be single-sided. 

Alternate record for reporting time worked. Click on the tabs at the bottom of the spreadsheet for the pay period in which you are recording time worked.

Owner automobile mileage report

日本一本道a不卡免费Report of miles driven for dealer-owned automobiles.

Out-of-state employee

日本一本道a不卡免费Approval of out-of-state employee - New Hire or Relocation.


Name Purpose - Description

Pay Option Agreement

日本一本道a不卡免费The form used by faculty and academic professionals on academic year appointments to change their pay schedule.

Payroll Action Request

The form used by managers if an additional payment needs to be made to a faculty or staff member.

日本一本道a不卡免费Payroll Packet

日本一本道a不卡免费See the new hire packet.

All of these forms are on the Performance Management website:

  • Performance Evaluation-Management.
  • Performance Evaluation-Staff.
  • Performance Improvement Plan.
  • Performance Development Plan Template.
  • Staff Self-evaluation Sample Form.
  • Manager Self-evaluation Sample Form.

日本一本道a不卡免费Report changes to personal information for current ASU employees. Use the My Profile tab.

Personnel File Request

日本一本道a不卡免费ASU employees should use this form to request access to view an employee's personnel file.

Pre-Employment Inquiry

日本一本道a不卡免费To be filled out by job candidates before a background check or fingerprinting is done.

Recruitment Handbook

Use for guidance in recruiting faculty and academic professionals.


Retirement program


日本一本道a不卡免费Administered by the Arizona Department of Administration, Benefit Services Division.

Election of Retirement Option

Use to elect retirement option.


Arizona State Retirement System

日本一本道a不卡免费Use for Public Service Purchase.

Use for Military Service Purchase.

Age 65+ Membership Waiver

This waiver form must be filed with ASRS within 30 days of employment.

Enrollment/Registration Instructions.

ASRS Reimbursement of Medical and Dental Cost Instructions-Forms

日本一本道a不卡免费This form is used by eligible retirees and LTD participants to request reimbursement of premiums, if they have insurance coverage, either as a policyholder or a dependent, under an employer’s active group plan.

日本一本道a不卡免费ASRS retirees must complete the online form to report the terms of their employment with an ASRS employer.

Name Change

  • - For ASRS members who need to change their name and/or address in the ASRS records and systems.
  • ASU - Form for employees to use to request a name change.

Form to be completed when an employee has left the University and wants to withdraw their contributions.


Public Safety Personnel Retirement System

日本一本道a不卡免费Form to be completed when designating a new beneficiary for PSPRS.

Use for refunds from PSPRS.

日本一本道a不卡免费For new PSPRS Members.

日本一本道a不卡免费Use to change name or address with PSPRS.


Retiree Accumulated Sick Leave program

Retiree Accumulated Sick Leave Program

Note: The original RASL application and instructions, checklist, Federal W-4 and Arizona A-4 forms are required and must be submitted to OHR Benefits within 150 days of retiring. The Deferral Notification form is optional and is submitted to Nationwide Retirement Solutions as instructed on this form.    

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Name Purpose - Description

  • Offer letters will be automated for all Staff, Student and Graduate Assistant hires through Kenexa BrassRing starting Nov. 18, 2013. The templates below are applicable only for the final recruitments being closed through PeopleSoft TAM.
  • Use these sample templates to confirm Classified or Service Professional employment offers.
  • Applicant - Use as a template to notify applicants that they were not selected.
  • Interviewee - Use to notify applicants that have been interviewed, that they were not selected.

Summer Address

Provide HR with your summer address information.

Temporary Employment Request

  • External  - Use when completing a Temporary Employment Request with an external temporary agency.
  • Internal - Use this form when completing a Temporary Employment Request with Staffing Services.

Timesheet Enhancement Documentation

Technical info about enhancements made to the online timesheet for hourly non-exempt and student employees paid from project sponsored accounts.


Tuition reduction program

Tuition reduction | ASU

Classes at any ASU campus | employee, employee's spouse, employee's dependents

International Employees - living outside the USA

日本一本道a不卡免费Classes at any ASU campus | Employee, Employee's spouse, Employee's dependents

Tuition reduction | not ASU

Classes at UA or NAU | Employee, Employee spouse, Employee dependents

Classes at ASU, UA or NAU:

  • Retiree, their spouse and dependents.
  • Eligible LTD participant, their spouse and dependents.
  • Affiliate, their spouse and dependents.

For HR signature do one of the following:

  • Fax the completed form to 480-965-1971 with instructions on where to return it.
  • Bring the completed form to the HR Employee Service Center.


Name Purpose - Description

Veteran Self-Identification

日本一本道a不卡免费This Protected Veteran Post-offer Invitation to Self-identify form is for military veterans only in four specific categories.

W-2 Request

Use this form to request a duplicate copy of a W-2 or 1042S.

日本一本道a不卡免费Employee's Federal Income Tax Withholding Allowance Certificate.

Waiver of Right to Pre-termination Hearing

Form to be used if you have been notified to attend a pre-termination hearing and you will not attend.

Waiver of Recruitment Faculty-Postdoc

This form replaces the focused recruitment form and is applicable for faculty and postdoc waivers of recruitment.

日本一本道a不卡免费Workers' Compensation

Packet includes instructions and forms that must be completed to file a workers' compensation claim.