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HUMAN RESOURCES

Forms:

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Title	Remarks	Agency
Accident Report - Supervisor	If there is an accident while on duty, the employee's supervisor must complete an accident report and submit it to HR.	GCC
Accident Report - Employee	If there is an accident while on duty, the employee must complete an accident report and submit it to HR.	GCC
Background Investigations	Release form.	GCC
Computer Ethics Agreement	Information concerning any access and use of information technology systems.	VCCS
Direct Deposit	Authorization to have check automatically placed in bank account.	GCC
Employee Self Assessment Form	Used by Employees to document their accomploishments as well as areas of improvement to assist supervisor in completing a thorough evaluation of performance.	DHRM
Employee Work Profile (EWP)	Employees duties/responsibilities	DHRM
Extraordinary Contributor	Use when documenting/recognizing an extraordinary contribution made in the performance of duties.	DHRM
Flexible Reimbursement Account Election Form	Use this form to enroll in or make changes to your Flexible Reimbursement Accounts (FRAs) or enroll/make changes online at Employee Direct.	DHRM
Immediate Recognition Award Form	Form used by supervisors to recognize individuals or teams for extraordinary contributions or outstanding performance.
Interim Evaluation Form	All NEW employees should have an Interim Evaluation Form completed within 90 days of hire.	DHRM
I-9 Form	ALL Employees Part-time/full-time must complete	Federal
Leave Request Form (Exempt Staff Only)	Exempt employees (those that do not complete a timesheet) must complete and submit to supervisors prior to taking leave.	GCC
Pay Action Worksheet	Use for CLASSIFIED Staff Pay Changes.	DHRM
Personnel Request Form	Use when requesting a position be opened, or when changing the number of hours applied to an existing P-14 position.	GCC
Purchase of Prior Service Application	Complete this form to apply for the purchase of prior service credit.	VRS
Reference Check Form	Use when checking references on a potential hire.	GCC
Salary Reduction Agreement	Use this form when authorizing payroll deductions for supplemental insurance policies and pre-tax annuities.	DOA
VCCS-10	Faculty Qualification Summary	VCCS
VA-4 (Tax Form)	Virginia Personal Exemption Worksheet is used to indicate the amount of tax dollars you want withheld from your pay.	State
W-4 (Tax Form)	Use to indicate the amount of tax dollars you want withheld from your pay.	Federal

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