Forms A-Z

NOTE: Some of these form links will take you to a site away from the MUW website.

Background Check Release AuthorizationCall Human Resources x7222
Banner Access RequestElectronic Form is available on the ITS Website. Select Banner, then Banner Access Request.
Banner Self-Service Instructions:
Pay Stubs[PDF]
W-2[PDF]
BENEFIT Forms: 
Benefits Election Form (all benefits EXCEPT State & School Employees’ Health/Life) [PDF]
Claim FormsDental (Guardian), Vision (Davis), Disability, Term Life (call HR Generalist x7222)
Guardian – Dental, Vision (Davis), Term Life, AccidentGuardian PDF
MedMutual – Cancer, Critical IllnessCancer PDF Critical Illness PDF
Reliance Standard – Disability, Term LifeDisability PDF Term Life PDF
State & School Employees’ Health Insurance ApplicationHealth PDF
State & School Employees’ Life Insurance ApplicationLife PDF
State & School Employees’ Life Insurance Beneficiary Designation (Minnesota Life/Securian)Click here for instructions to change your beneficiary designation on-line. Or, complete the [PDF] form and submit to Human Resources. (Links take you off-site.)
State & School Employees’ Health Insurance & CVS Caremark Online Registration Click here for instructions to create an account and access electronic insurance cards.
Change of Address
Call Human Resources x7222
Confidentiality Agreement[PDF]
Deferred Pay Form (Faculty)[PDF]
Employee Certification and Authorization Form[Word]
Employee Personal Information Form[PDF]
Employee Transfer Checklist – Current Department[Word]
Employee Transfer Checklist – Receiving Department[Word]
Employee Time Log (For all Benefits-Eligible Biweekly Employees)
Email cajernigan1@muw.edu for a copy of the time log.
Employee vs Independent Contractor Checklist[Word]
Flex Time Approval Form[Excel]
Job Evaluation PacketThis form is being updated. Email lsquinn@muw.edu for a copy of the JEP.
Justification and Approval for Adjunct Teaching or Additional Duties (Staff)[PDF]
Leave – Application for Leave[PDF]
Leave – Instructions for Entering & Approving Leave in Banner Self-Service and Leave FAQs[PDF]
Leave Form – Biweekly Non-Exempt Employee Attendance/Leave Record[Excel] or email cajernigan1@muw.edu for a copy of the12-month master spreadsheet.
Leave Correction/Late Forms: 
Exempt Employee Form[Excel]
Less Than 12 Month Faculty Form[Excel
Non-Exempt Employee Form[Excel]
Leave Donation Eligibility Form[PDF]
Leave Donation Form (Staff)[PDF]
Leave Donation Form (Faculty)[PDF]
Leave Guidelines[PDF]
Meal Plan Form[PDF]
Medical Certification Form (Employee)[PDF]
Medical Certification Form (Family Member)[PDF]
Notice of Intention to Return from Medical Related Leave[Word]
Onboarding Checklist for Supervisors[Word]
Paycheck Authorization Form
Call Human Resources
Personnel Action Form (PAF)[PDF | Word (fill-in format)]
PERS Form 4A [PDF]
Reasonable Accommodations Request Form[Word]
Request for Outside Employment – Consultation and Research (Faculty)
[Word]
Request for Outside Employment (Staff)[Word]
Sponsored Programs Personnel Action Form[ PDF | Word]
Student Worker Time Log (Time Entry Time Sheet – Use as Excel Document – Do Not Handwrite)
[Excel]
Summer Flex Program Guidelines, Examples, and FAQs[PDF]
Summer Flex Schedule Request Form[Excel]
Tax Deferred Annuity Form (for new TDA or change)[PDF]
Tax Form – Form W-4 Employee’s Withholding Allowance CertificateLink takes you to an off-site link. Form W-4 2024
Tax Form – Mississippi Withholding Exemption CertificateLink takes you to an off-site link. MS Tax Withholding Form
Teleworking – Job Analysis[Word]
Teleworking – Temporary Agreement[Word]
Tuition Remission Form (Employee/Retiree)
Form is available on the Financial Aid website under Forms. Financial Aid Forms
Tuition Remission Form (Dependent Child)Form is available on the Financial Aid website under Forms. Financial Aid Forms
Tuition Remission Form (Spouse)Form is available on the Financial Aid website under Forms. Financial Aid Forms
Veteran’s Self-Identification Form[Word]
Voluntary Self-Identification of Disability FormLink takes you to an off-site link. DOL Voluntary Self-ID Form
Workers’ Comp FormFirst Report of Injury (Form & Instructions) Complete all applicable yellow highlighted boxes and SUBMIT TO THE HUMAN RESOURCES OFFICE.[PDF]

Notes:

– PDF format is PRINT ONLY which requires free Acrobat Reader
– Right click on “Excel or Word file” and save the file to a local directory
– For Word Fill-in Forms – Save form to your computer, in Word, on the “Forms” toolbar, click the “lock” or “protect form” once document is open.