Forms


BENEFITS FORMS


HEALTH BENEFITS FORMS:

arrow  Aetna Medical Claim Form 

arrow  Aetna Dental Claim Form

arrow  Aetna/PayFlex FSA Claim Form 

arrow  CVS/Caremark Prescription Reimbursement Claim Form

arrow  EyeMed Vision Claim Form



EDUCATIONAL BENEFITS FORMS:

arrow  Tuition Reimbursement Application & Tracking (online form)

 

FINANCIAL SECURITY BENEFITS FORMS:

arrow  Life Insurance Evidence of Insurability (EOI) Form (online form)

arrow  Life Insurance Beneficiary Statement Form

arrow  Long Term Disability Claim Form

arrow  Long Term Disability COLA (Cost of Living Adjustment) Enrollment Form



RETIREMENT BENEFITS FORMS:

arrow  457(b) Fidelity Custodial Account Application

arrow  457(b) TIAA-CREF Enrollment Form

arrow  457(b) Vanguard Account Application

arrow  457(b) Deferred Compensation Agreement Form

arrow  Retirement Contribution Change Form (online form)

 

OTHER BENEFITS FORMS:

arrow  Same Sex Domestic Partner Affidavit

arrow  Same Sex Domestic Partner Termination Form



HIRING FORMS

arrow  Age Certification Form

arrow  Consent to Personal Records and History Release Form

arrow  I-9 Form

arrow  Moving Expense Report

arrow  Residency Questionnaire (Windstar Technologies)

arrow  W-8BEN Form

arrow  Volunteer Request Form

arrow  Volunteer Release, Covenant Not to Sue and Assumption of Risk





LEAVE AND TIME KEEPING FORMS


arrow  Non Medical Leave Request Form 

arrow  Request for Leave Form for Bi-Weekly Employees

arrow  FMLA and Medical Leave (online form)

arrow  Monthly Staff Leave Requests (online form)

arrow  Kronos Information (bi-weekly hires, re-hires, transfers)

arrow  Kronos Instructions (bi-weekly employees)




PAYROLL AND FINANCE FORMS


arrow For all Payroll and Finance Department Forms, visit: https://www.finance.emory.edu/home/payroll/forms.html




PERFORMANCE MANAGEMENT FORMS


arrow  For Performance Management Forms, go here




OTHER FORMS


arrow  Employment Verification Authorization Form

arrow  Emory University Suspected Child Abuse Reporting Form

arrow  Personal Information Change Form