FORMS

Accident/Incident Report Form

Background Check Authorization Form

Comp Time Agreement

Emergency Personnel Designation Memo

Employee Separation Checklist

Improvement Plan

Monthly Work Record
Instructions for Monthly Work Record

New Employee Checklist
I-9 List of Acceptable Documents

New Employee Information Sheet

Non-Classified Employee Position Description

Permission to Recruit

Personnel Action Form

Position Information Questionnaire (PIQ) for Classified Employees
Instructions for Completing PIQ

Sick Leave Buy Back Forms

Spouse and Dependent Waiver Application

Staff Development Funds Application

Staff Performance Evaluation Form

Direct Deposit Authorization Form

I-9 Form

Maryland State Withholding Form

Payroll Deduction Agreement

Salary Reduction Agreement

Virginia State Withholding Form

W4 Form

West Virginia State Withholding Form

ADA Accommodation Request

Catastrophic Leave Forms

Medical Leave Verification

Medical Release to Return to Work

Mountaineer Flexible Benefits Form for Active Employees

Mountaineer Flexible Benefits Form for Retirees

PEIA Basic Life Insurance Form

PEIA Change-in-Address Form

PEIA Change-in-Status Form

PEIA Health Benefits Enrollment Form

The Standard Long Term Disability Enrollment Form

Workers' Compensation Temporary Total Disability Benefits or Sick Leave Benefits