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A

Accidental Death& Dismemberment Claim Form
Acknowledgment of Driver License Requirement
Administrative Rule Waiver Request 
Administrative Rule Waiver Request: Extension of Eligible List
Affidavit as to Forged Endorsement
Affidavit of Common Law Marriage
AFSCME Third Bumping Option
Agreement for Recouping Education Payments
Agreement for Recouping Relocation Payments
Alternative Duty Assignment
AO Safety Glasses Form
Appeal Board Administrative Form
Application for Supplemental Term Life Insurance
Application to Volunteer for Layoff For AFSCME-Covered Employees Only
Authorized Signator Form

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B

Background Check Policy Template
Bargaining Exemption Questionnaire
Building Access Identification Cards

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C

Calculate Market Value Differential
Calculating Mortgage Interest Differential
Calculation of AFSCME Seniority
Calculation of Income Tax Assistance Payment
Calculation of UE/IUP Seniority - Science Unit
Calculation of UE/IUP Seniority - Social Services Unit
Capitol Complex Events Form
Capitol Complex Grounds/Administration Buildings Form
Certificate of Creditable Coverage - Health
Certificate Program Enrollment Forms
Certification of Full-Time Student Status
Certified Public Manager (CPM) Application
CFN 552 Refund Form
CFN 552 State Share Transfer
CFN 552 TRA Form
CFN 552 Transfer Between Carriers Form
COBRA Notification/Election form
Commercial Driver License Supplement Application
Complaint Form, Employee
Confidential Personal Data Form
Confined Space Entry Permit (Permit Required)
Confined Space Pre-Entry Checklist (Non-Permit Spaces)
Correction Document Expenditure - Excel Version
Correction Document Expenditure - Word Version
Correction Document Revenue - Word Version
Correction Document Revenue - Excel Version
CR Cash Receipt Treasurer's Document

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D

Delta Dental Insurance Application
Departure Survey Employee Information
Dig Application
Direct Pay Continuation Form
Donated Leave Application
Donated Leave Application for Family Members
Domestic Partner Affidavit
Domestic Partner Termination
Donated Leave Contributions
Donated Leave Contributions for Family Members
Donated Leave Request
Donated Leave Request for Family Members
Donated Leave Tracking
Donated Leave Tracking for Family Members
Double Spouse Credit Toward Family Dental and Health Insurance
Duplicate Warrant Affidavit

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E

Education Payments: Agreement for Recouping Education Payments 552-0707
Educational Directory order form
Education Leave and/or Education Financial Assistance Application
EFT Authorization State of Iowa Vendor Use Only (Not for Employee Payroll Use) 
Emergency Procurement Justification Form
Employee Request for Emergency Evacuation Assistance
Employee Separation Form
Evacuation Assistance form, Employee Request for
Exit Information Questionnaire Part 1
Exit Information Questionnaire Part 2

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F

First Report of Injury or Illness
FMLA - Employee Rights and Responsibilities
FMLA - Leave Retention
FMLA - Return to Work Certification

FMLA forms for use only by Community-Based Corrections (CBC), Judicial Branch, and State Fair employees.

FMLA - Application and Intent to Return to Work
FMLA - Cert. of Health Care Provider for Employee's Serious Health Condition
FMLA - Cert. of Health Care Provider for Family Member's Serious Health Condition
FMLA - Cert. of Qualifying Exigency for Military Family Leave
FMLA - Cert. for Serious Injury/Illness of Covered Service Member for Military Family Leave 
FMLA - Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
FMLA - Designation Notice
FMLA - Notice of Eligibility and Right & Responsibilities

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G

General Accounting Expenditure - Word Version
General Accounting Expenditure - Excel Version
GAXN-Excel Version
GAXN-Word Version
GAXR-Excel Version
GAXR-Word Version

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H

Health Insurance Application: Regular Health Plans (except Blue Advantage)
Health Insurance Application: Blue Advantage 
Health Insurance Application: Alliance Select (SPOC-covered employees only) 
Hiring Justification
Hot Work Permit

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I

IET Internal Exchange Transfer-Excel Version
IET Internal Exchange Transfer-Word Version
IET for PROD Interfaces - Word Document
IET for PROD Interfaces - Excel Document

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J

Job Evaluation Questionnaire
JV1 Correcting Journal Voucher-Excel Version
JV1 Correcting Journal Voucher-Word Version
JV1N-Excel Version
JV1N-Word Version
JV1R-Excel Version
JV1R-Word Version

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K

L

Lease Agreement, State of Iowa 
Life Insurance - Beneficiary Designation Form 
Life Insurance - Claim Form 
Life Insurance - Enrollment Form 

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M

MD Cover Sheet
MD-Excel Version
MD-Word Version
Merit Exempt Questionnaire
Motor Vehicle Law Conviction Notice
Mover Planner Worksheet
Moving Company Bid

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N

Non-Contract Grievance form

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O

Office Space Allocation Form 
Online Learning Registration Form

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P

P17 Electronic Work Comp
P-30
Parking Decal Application
Pay Grade Study Questionnaire
PDS Course Registration Form
Performance Plan and Evaluation Form
Permit-Required Confined Space Entry Permit 
Personnel Mobility Assignment Agreement
Personnel Services Pre-Contract Questionnaire
Position Description Questionnaire
Pre-Auditor's Authorized Signator Form
Pre-Entry Checklist for Non-Permit Confined Spaces

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Q

R

Reasonable Accommodation Request 
Request for Adaptive Google Software
Recall Enrollment
Relocation: Agreement for Recouping Relocation Payments 552-0751
Relocation Expense Recap (sample)
Relocation TP & JV1 Cover Sheet
Request for Classification, Compensation and Selection Changes
Request for Exception to Statewide Policies
Request for Flat WH Rates
Request for Outstanding Warrant Action
Request to Establish New Fund
Request for Selective Certification Additions or Changes
Requisition for Goods & Services Form
Retention Point Calculation Worksheet
RIC Account Form
RIC Beneficiary Form (fill-in)
RIC Beneficiary Form (printable)
RIC Distribution Form
RIC Rollover Form
RIC Unforeseeable Emergency Form

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S

Separation Checklist
Short Form SS-8
Signature Authorization form
SLIP - Enrollment Form
SLIP - Calculation Worksheet
SLIP - Application for Continuation in the Retired/Disabled State Group Health or Dental Insurance
SLIP - Executive Branch Non Contract SLIP Retiree Wellness Participation
SLIP -  Enrollment Checklist for Human Resources Associates
SLIP - Retiree Rehire Authorization
Sole Source Purchase Form
Space Allocation Form 
Special Pay/Appointment Action
Specials Cover Sheet
SPOC Retiree Vacation to Sick Leave Conversion
SPOC Vacation to Sick Leave Conversion 
State of Iowa Employment Application
Statement of Ownership of Principle Residence
Substitute W-9 Vendor
Summary of Internal Policies for Claims Crossing FY
Supervisory Analysis Questionnaire
Supplemental Life Insurance Application Form 
Supplemental life Insurance, Request to Decrease

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T

TA (PERM)-Excel Version
TA (PERM)-Word Version
TA (TEMP)-Excel Version
TA (TEMP)-Word Version 
TAPE Cover Sheet
TE-Excel Version
TE-Word Version
Temporary Staffing Services Vendor Request 
TP (Travel Payment)-Excel Version
TP (Travel Payment)-Word Version
TPN-Excel Version
TPN-Word Version
TPO-Excel Version
TPO-Word Version
TP-RELO EXP-Travel Payment for Relocation Expense
TP-RELO-SUB-Travel Payment for Relocation Subsistence
TPR-Excel Version
TPR-Word Version

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U

V

Vehicle Accident Report Form
Vendor Complaint Form
Vendor Conversion Form

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W

Waiver of Life Insurance Form
Wallace Auditorium Reservation Form
Workers' Comp Benefit Election Form
Workers' Comp Travel Reimbursement Request
Workers' Comp Wage Statement 
Workplace Violence Report (see Complaint Form, Employee)

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X

Y

Z

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