Personnel-Related Forms

Unless otherwise indicated, these forms are provided in MS Office Word format.  If you do not have MS Word, you can download a freeware copy of any of the Microsoft Word Viewers which are available from Microsoft. Microsoft provides detailed information with each copy of these programs including instruction for installation and use.

Documents in PDF format can only be viewed and printed by using an Adobe Acrobat Reader

ACE/ERA Request Form (Word - 75 KB)

Appeal Form (Word - 101 KB)

Annual Leave Sharing Information (Word - 47 KB)

• Application (Word - 62 KB)
• Donation Form (Word - 72 KB)
• Transfer-Credit Form (Word - 68 KB)

Authorization for Returning Retirees replaced by Member and Employer Certification Regarding Reemployment (PDF - 17 KB)

Cooperative/Internship Education

• KY Cooperative/Internship Education Application Supplement (Word - 59 KB)
• Coop-Intern Program Performance Evaluation Form (Word - 84 KB)
• Coop-Intern Program Performance Evaluation Form (PDF - 72 KB)

Educational Leave Contract (Word - 30 KB)

Employee Performance Evaluations:

New forms effective for use beginning 1/1/12:

• Instructions for Using New Forms (Word - 93 KB)

Excel Version: (all forms contained within one document/performs math calculations)

• Annual Employee Performance Evaluation (Excel - 185 KB)

Word Version: (all forms are separate documents/does NOT perform math calculations)

• Plan - Part A (Word - 96 KB)
• Plan - Part B (Word - 116 KB)
• Continuation Sheet (Word - 147 KB)
• Continuation Sheet - DUTIES Only (Word - 168 KB)
• 1st Interim Review (Word - 47 KB)
• 2nd Interim Review (Word - 47 KB)
• 3rd Interim Review (Word - 50 KB)
• Final Evaluation (Word - 70 KB)

Word Version: (certain and/or all forms combined into single documents/does NOT perform math calculations)

• Plan and Final Evaluation (Word - 504 KB)
• All Interims (Word - 98 KB)

Fair Labor Standards Act Info and Forms

• Instructions for Completing Excel FLSA Exempt Test
• FLSA Exempt Test and Form (Excel - 114 KB)
• FLSA Exempt Test (Word - 52 KB)
• FLSA Exempt Form (Word - 32 KB)
• FLSA Exempt Test (PDF - 72 KB)
• FLSA Exempt Form (PDF - 53 KB)

FMLA Information (Word - 55 KB)

• Application (Word - 71 KB)
• Health Care Provider Certification for Employee (PDF - 622 KB)
• Health Care Provider Certification for Family Member (PDF - 589 KB)
• Letter of Designation (Word - 50 KB)

Overtime Compensation Election Form (Word - 52 KB)

Personnel Action Exemption Form (Excel - 110 KB)

Position/Personnel Action Requests (Excel - 465 KB)

Pre-Termination Hearing Form (Word - 146 KB)

Previous Qualifying Service Certification Form (Word - 29 KB)

Records Request Forms

• Employee-Applicant Request for Inspection of Records
• Request to Inspect or Copy Public Records (Word - 46 KB)

Request for Dual Employment (Word - 50 KB)

Request for Educational Achievement Awards (Word - 153 KB))

Sick Leave Sharing Information (Word - 64 KB)

• Application (Word - 63 KB)
• Donation Form (Word - 71 KB)
• Transfer-Credit Form (Word - 67 KB)

Signature Authorization Forms

• Signature Authorization Form (Word - 31 KB)
• Signature Authorization Revoke Form (Word - 27 KB)

State Service Request Form (Word - 36 KB)

Voluntary Transfer/Demotion/Salary Retention Agreement Form (Word - 43 KB)

Work County Change - Voluntary Example Letter (Word - 39 KB)