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Kansas State University

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

Numerical List of Forms
FORMS Number & NameDatedInstructions
or Information
AA-28,   Initial Screening of Candidates Prior to Interview   Instructions RTF Word PDF Excel
DA-6P,   Paycheck Stop Payment Request 05/2006 Information NA NA PDF Excel
DA-22,   Agreement for Reimbursement of Moving Expenses 11/1998 Moving Expenses RTF Word PDF  
DA-244,   Performance Management Process Form 2013-2014 Performance Management Process
RTF Word PDF  
DA-281-2,   Position Description (Classified) (Special) 2/2014 PPM 4210
Position Descriptions Checklist
RTF Word PDF  
DA-2004a,   Tax Clearance Information Form for Candidates and New Hires 05/2004 Information     PDF  
DPS-417,   Substance Abuse Policy Affirmation Form 5/2007 Information RTF Word PDF  
I-9,   Employment Eligibility Verification 03/2013 Included NA NA PDF  
K-4,    Kansas Employee's Withholding Allowance Certificate 09/2007 Information     PDF  
KPERS 79,   Optional Group Life Reduction/Cancellation Form 09/2003 Optional Life     PDF  
KPERS-7/99,   Beneficiary Basic/Optional life insurance KPERS employees 04/2011 PPM 4820.60     PDF  
KPERS-7/99A  Beneficiary Basic/Optional ife insurance Board of Regents employees 6/2010 PPM 4820.60     PDF  
PER-3,   Above Step Request 8/2011 PPM 4450.30 RTF Word PDF  
PER-5,   Request for Certified Names 11/2012 Instructions
Department Recruitment Procedures
PER-7,    Departmental Employee of the Year Award & Recognition Program Monetary Award Payment Form Guidelines RTF Word PDF  
PER-8,   Supplemental Pay Form     RTF Word PDF  
PER-9,   Leave Balance Correction Sheet 10/2013 Information RTF Word PDF  
PER-10,   Affirmative Action Classified Selection Report   Included
Affirmative Action-Recruitment
PER-13,   Investment Agreement - Mandatory Retirement Plan (Kansas Board of Regents) 06/2012 PPM 4810.20     PDF  
PER-15,   KSU Foreign National Tax Information Form 07/2007 Included
Visa Classifications
RTF Word PDF  
PER-16,   Exit Interview for Classified Employees 10/2013 PPM 4950.15 RTF Word PDF  
PER-17,   Accident/Injury Report (Workers' Compensation) (do not use after April 30, 2014) 02/2010 PPM 4820.100 RTF Word PDF  
PER-19,   Investment Agreement - Voluntary Pre-Tax Retirement Plan 02/2013 PPM 4810.80     PDF  
PER-19R,   Investment Agreement - Voluntary Roth After-Tax Retirement Plan 02/2013 PPM 4810.80     PDF  
PER-20,   Faculty and GTA Spoken English Competency Assessment Sheet 08/2010 Included
Graduate Student
RTF Word PDF  
PER-21,   Agreement for School Employee Appointment 08/2013   RTF Word PDF  
PER-22,   Affiliated Person or Emeritus Faculty Form (PER-22) 7/2013 Included RTF Word PDF  
PER-23,   Position Description (Unclassified Professional Positions) 08/2011 Instructions
Position Descriptions Checklist
RTF Word n/a  
PER-24,   Employee Separation Checklist 06/2011 Classified Separations
Unclassified Separations
PPM 4950
RTF Word PDF  
PER-25,   Educational Authorization Form 5/1998 PPM 4870.20 RTF Word PDF  
PER-26,   Annual Review of Classified Position Descriptions 11/2012 PPM 4210 RTF Word PDF  
PER-28,   Agreement of Understanding for Overlapping Appointment 10/2004 Military Service Policy RTF Word PDF  
PER-29, Student Employee Performance Review 05/2004 PPM 4720#130 RTF Word PDF  
PER-33,   Documentation of Service for Immediate Participation in Regents Retirement Program 06/2012 PPM 4810.20     PDF  
PER-34,   Overtime Compensation Agreement for Non-Exempt Employees 02/2007 PPM 4220.70 RTF Word PDF  
PER-36, Position Data Sheet 07/2013 Unclassified
RTF Word PDF  
PER-37,   Notification of Retirement 6/2009 PPM 4810 RTF Word PDF  
PER-38,   Appointment Form 07/2013 Unclassified
RTF Word PDF  
PER-39,   Change or Separation Form 07/2013 Unclassified
Grad Student
RTF Word PDF  
PER-40,    Hourly Student Data Sheet 02/2013 Instructions
RTF Word PDF  
PER-41,    Graduate Student Appointment Form 02/2013 Instructions RTF Word PDF  
PER-43,   Agreement for Limited Term Appointment 10/2004 PPM 4460.40 RTF Word PDF  
PER-44,    Funding Data Sheet 04/2009 Instructions     PDF Excel
PER-45,   9 Month Unclassified Summer Transactions 04/2013 Instructions RTF Word PDF  
PER-46,   Mid Year Base Salary Increase Form 12/2003 Included RTF Word PDF  
PER-58,   Direct Deposit of Employee Pay 12/2010 Instructions
RTF Word PDF  
PER-59,   Background Check Request Form 01/2013 Background Checks
Background Check Form Instructions
RTF Word 2010 PDF  
PER-60,   Advance Leave Agreement 10/2009 Leave Advancement Policy RTF Word PDF  
PER-61,   Request for Classified Position Reassessment 02/2010 Information RTF Word PDF  
PER-62,   Position Analysis Questionaire 02/2010 Information RTF Word PDF  
PER-63,   Out-of-Office Availability Addendum 05/2011 PPM 4660RTFWordPDF 
PER-64 A&B,   Shared Leave Request Form 3/2013 Instructions RTF WordPDF  
PER-64 D,   Shared Leave Donation Form 4/2012 Instructions RTF WordPDF  
W-4,   Employee's Withholding Allowance Certificate
Update online in Employee Self Service
2014 Included
W-9,   Request for Taxpayer Identification Number and Certification 8/2013 Included     PDF