Forms Directory

A list of HR-related forms.

Human Resources Forms

**Frequently Requested Forms**
HR 19-Permission to Take a Course	View Policy Request Form 19
Outside Employment Form (Formerly Form 9) Permission to Engage in Outside Employment	View Policy PDF Secure Upload (For use after Department Director/Dean/VC (excluding VCAF) signature)
Reasonable Suspicion Record Form	Policy Information
Form 13-S Supplement to Electronic Form HR 13	PDF

**Benefits-Related Forms (Insurance, Leave, Workers' Compensation, etc.)**
Benefits Change of Address Form (Please use myOleMiss to make address changes. This form is to be used only if you do not have access to myOleMiss.)	PDF
UNUM Beneficiary Designation Form	PDF
State Life Insurance Beneficiary Designation	PDF
AD&D Beneficiary Designation Form	PDF
Insurance Claim Form for Delta Dental	Delta Dental
Insurance Claim Form for Davis Vision	PDF
Insurance Claim Form for Colonial Life and Accident Death	Colonial Life
Claim Form for Cancer, Dreaded Disease and Intensive Care	PDF
Request for Reimbursement Form for Flexible Spending Accounts with Southern Administrators & Benefit Consultants	Submit a Claim \| SABC
Change of Information for the Public Employees' Retirement System	Form 1C \| PERS
Public Employees' Retirement System of MS Beneficiary Designation Form	Form 1B \| PERS
Workers' Compensation First Report of Injury	PDF
Workers' Compensation Employee Claimant Packet	PDF

**E-Form Administration**
E-form program on myOleMiss	myOleMiss Form
Request Access to E-form	Request Form
E-form Delegate Request Form	PDF

**Flexible Work Location**
Flexible Work Location Request	Policy Information PDF Form
Flexible Work Location Arrangement Form	Policy Information PDF Form
UM Telework IT Checklist	PDF Form

**Payroll**
Timesheet - Student	Submitting Your Timesheet Excel Form
Timesheet - Non Exempt/Hourly	Submitting Your Timesheet Excel Form
Timesheet - Exempt/Salary	Submitting Your Timesheet Excel Form
Timesheet - Rebel Reserve	Submitting Your Timesheet Excel Form
Payroll Time Conversion Chart	PDF
Off-Cycle Request Form	PDF

Recruitment

For Recruitment related documents and forms, please use your Ole Miss webID and password to login to connectU. These below documents can be found by selecting the “Click Here for connectU Resources” box.

Search Committee Guide
Job Requisition Intake Form
Sample Interview Questions
Sample Reference Check Questions
Confidentially Agreement

**Separation of Employment**
Exit Checklist	Separation of Employment PDF
Separation Notification	Separation Notification Form
Student Exit Checklist	PDF

The following can be accessed at my.olemiss.edu

Address Change
W-2 Opt-In
W-2
Pay Stubs
Timesheets
Office Contact Information
Emergency Contact Information
Bank Information
Travel
Benefits Confirmation Statement
Open Enrollment