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Forms - HR

by Wright State University

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Name Description Released Price

1 Certification of Tax-Qualified Dependents -- 11/5/07 Free View In iTunes

2 Anthem Medical (out of network) Claim -- 11/5/07 Free View In iTunes

3 Dental Claim -- 11/5/07 Free View In iTunes

4 Termination of Domestic Partnership -- 11/5/07 Free View In iTunes

5 Flexible Spending Account Claim -- 11/5/07 Free View In iTunes

6 Flexible Spending Account Election / Change -- 11/5/07 Free View In iTunes

7 Orthodontic Claim - Flexible Spending Account -- 11/5/07 Free View In iTunes

8 Prescription Drug Claim -- 11/5/07 Free View In iTunes

9 United Health Care Medical Claim -- 11/6/07 Free View In iTunes

10 United Health Care Pharmacy Claim -- 11/6/07 Free View In iTunes

11 Address / Name Change -- 11/6/07 Free View In iTunes

12 Application for Fee Remission Authorization -- 11/6/07 Free View In iTunes

13 Classified Employment Application -- 11/6/07 Free View In iTunes

14 Direct Deposit Authorization -- 11/6/07 Free View In iTunes

15 Performance Appraisal Cover Sheet -- 11/6/07 Free View In iTunes

16 Probationary Appraisal -- 11/6/07 Free View In iTunes

17 Dependent Statement for Fee (Tuition) Remission Authorization -- 11/6/07 Free View In iTunes

18 Vacation/Sick Leave Summary -- 11/6/07 Free View In iTunes

19 Announcement of Position Vacancy -- 11/6/07 Free View In iTunes

20 Position Description -- 11/6/07 Free View In iTunes

21 State of Ohio W-4 tax form Rev. 5/07 -- 12/18/07 Free View In iTunes

22 Personnel Action Form -- 6/2/08 Free View In iTunes

23 Affidavit of Domestic Partnership -- 10/30/08 Free View In iTunes

24 Domestic Partner Certification Checklist -- 10/30/08 Free View In iTunes

25 Health Care Enrollment / Change -- 11/18/08 Free View In iTunes

26 2008 IRS Form W-5 - Earned Income Credit Advance Payment Certificate -- 12/22/08 Free View In iTunes

27 2009 Form W-5 -- 12/22/08 Free View In iTunes

28 2010 Form W-5 -- 12/21/09 Free View In iTunes

29 Leave Request Form -- 8/21/09 Free View In iTunes

30 Tuition Remission Dependent Authorization Form -- 2/12/10 Free View In iTunes

31 Vision VSP (Out-Of-Network) Reimbursement -- 5/17/10 Free View In iTunes

32 Sun Life Beneficiary Designation -- 6/18/10 Free View In iTunes

33 Classified Job Audit / Review -- 6/29/10 Free View In iTunes

34 2012 Health Savings Account (HSA) Salary Reduction Agreement -- 1/23/12 Free View In iTunes

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Forms - HR

by Wright State University

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