Payroll Forms
- Authorization of Direct Deposit (PDF)
- Reversal of Direct Deposit (PDF)
- Election to Annualize Recurring Part-Year Compensation (PDF)
- Federal W-4 (2019) (PDF)
- Missouri W-4 (2019) (PDF)
- City of St. Louis Tax Withholding Form (PDF)
- Gift, Prize, or Award Form (PDF)
- Form I9: Employment Eligibility Verification (External Website)
- Personal Information Form – Employee (PDF)
- Personal Information Form – Non-Employee (PDF)
- Telecommuting Agreement and Assignment (PDF)
- Telecommuting Confidentiality & Security Policy Acknowledgement (PDF)
Benefits Forms
- Enrollment Change Form (PDF)
- Enrollment Change Form – Union Power Plant Employees (PDF)
- Postdoctoral Appointees Change Form (PDF)
- Clinical Fellows Change Form (PDF)
- Retiree Enrollment Form (PDF)
- Electronic Funds Transfer Form (PDF)
- Dependent Verification Affidavit Form (PDF)
- Dependent Verification Affidavit Form – Postdocs/Union Power Plant Employees (PDF)
- Domestic Partner Declaration Form (PDF)
- UnitedHealthcare Claim Form (PDF)
- UnitedHealthcare International Claim Form (PDF)
- Advantica Dental Claim Form (PDF)
- Express Scripts Claim Form (PDF)
To be completed only if you need to submit a claim for reimbursement - Express Scripts Mail-Order Form (PDF)
- Spouse/Domestic Partner Premium Surcharge Change Form (PDF)
- VSP Claim Form (PDF)
- ConnectYourCare Medical Expense Reimbursement Form (PDF)
Also known as the “Pay Me Back” form for Medical Expense - ConnectYourCare Dependent Child Care Benefits Reimbursement Form (PDF)
Also known as the “Pay Me Back” form for Child Care
- Life Insurance Enrollment/Change Form (PDF)
- Life Insurance Domestic Partner Declaration Form (PDF)
- Life Insurance Portability Rate Form (PDF)
- RA/GRA/SRA Comparison Chart (PDF)
- W-4P Form (PDF)
- Tenured Faculty Phased Retirement Program Application Form (PDF)
- Tenured Faculty Basic Phased Retirement Program Agreement Form (PDF)
- Tenured Faculty Enhanced Phased Retirement Program Agreement Form (PDF)
- Clinician Track Faculty Phased Retirement Program Application Form (PDF)
- Clinician Track Faculty Basic Phased Retirement Program Agreement Form (PDF)
- Clinician Track Faculty Enhanced Phased Retirement Program Agreement Form (PDF)
- RMSA Cancellation Form (PDF)
Complete Sections A,H,and I to cancel RMSA - RMSA Claims Activation Form (PDF)
- Undergraduate Employee Tuition Assistance Request Form (PDF)
- Graduate Employee Tuition Assistance Request Form – Job Related (PDF)
- Graduate Employee Tuition Assistance Request Form – Non-Job Related (PDF)
- Dependent Child Tuition Assistance Authorization to Release Information Form (PDF)
- Ex-Spouse Dependent Tuition Affidavit Form (PDF)
- Dependent Eligibility Affidavit Form (PDF)
- Spouse Tuition Assistance Request Form (PDF)
- Domestic Partner Tuition Assistance Request Form (PDF)
- Employee Taxation on Non-Job Related Tuition Form (PDF)
- Postdoctoral Appointees Tuition Assistance Form (PDF)
- Nursing Tuition Assistance Request Form (PDF)
FMLA Forms
- Family and Medical Leave Application Form (PDF)
- Certification of the Health Care Provider for Employee Leave Form (PDF)
- Certification of the Health Care Provider for Family Member Leave Form (PDF)
- Certification for Serious Injury or Illness of Current Service Member Form (PDF)
- Notice of Eligibility and Rights and Responsibilities Form (DOC)
- Certification of Qualifying Exigency for Military Family Leave Form (PDF)
- Certification for Serious Injury or Illness of a Veteran Form (PDF)
- FMLA Poster (PDF)
- FMLA Designation Notice
- Return to Work Form (PDF)
Other Leaves
- General Medical Leave Application (PDF)
- General Medical Leave Letter (PDF)
- Personal Leave Application (PDF)
- Personal Leave Letter (PDF)
Compensation Forms
Independent Contractor Status
Performance Management Forms
Employee Evaluation (New Condensed Format)
- Administrative/Support Evaluation Form – Condensed (RTF)
- Supervisory/Professional Evaluation Form – Condensed (RTF)
Employee Evaluation (Original Format)
- Administrative/Support Evaluation Form (DOC)
- Administrative Self Evaluation Form (RTF)
- Supervisory/Professional Evaluation Form (DOC)
- Supervisory Self Evaluation Form (RTF)
Career and Professional Development
- Competencies for Success at Washington University
- Individual Development Plan – Guidelines and Form (PDF)
- Career Development
HRMS Forms
- Deans, Department Heads, and Directors Label Request Form (PDF)
- HRMS Security Authorization Form (External Website)
- Miscellaneous Address Label Request Form (PDF)
- HRMS How-To Guide
- HRMS Action Reason Guide