Forms

Note: If you receive an error when trying to access a PDF file it means you need to download the PDF and open in Acrobat

HR Request Form

Please send all requests you would normally send to your HR Business Partner using the HR Request form. This includes Acting-In, Career Mobility, Incentive Plans, In-Grade and Grade Advancements, Job Description, Salary Reviews, Pay Equity Reviews, Reclassifications and Recruitment. Please attach the required documents.

Administration

Administration
File	Size
2022 Holiday Schedule	134 kB
Career Mobility Agreement	170 kB
Appointed Positions	91 kB
First Report Of Injury	303 kB
Gift Card Request	2374 kB
Termination Checklist	40 kB
Training Repayment Agreement	134 kB
Voluntary Furlough Request Form	88 kB
New Employee Onboarding Packet (for supervisors)	2419 kB

Report an On-The-Job Injury or Illness

Benefits

Benefits
File	Size
PEHP Group Term Life Change Form	255 kB

Classification

Classification
File	Size
Classification Appeal Hearing Officer Manual	138 kB
Condensed Position Description Questionnaire	239 kB
Job Description Template	58 kB
Position Classification Appeal Hearing Officer	170 kB
Position Classification Appeal Staff Review	121 kB
Position Description Questionnaire	333 kB

Employee Relations

Employee Relations
File	Size
Alcohol and Drug Reasonable Suspicion Checklist	166 kB
Designation of Representative	153 kB
Disclosure of Prescription Drugs	177 kB
Drug Screening Authorization Form	120 kB
EEO Complaint Form - Submit	225 kB
EEO Complaint Form - Withdraw	149 kB
Employee Grievance Form	71 kB
Employee Disciplinary Notice of Written Warning	1602 kB
Mediation Agreement Form	67 kB
Employee Disciplinary Notice Intent to Demote - Letter Template	25 kB
Employee Disciplinary Notice Suspend Without Pay - Letter Template	27 kB
Employee Disciplinary Notice Terminate - Letter Template	25 kB
Request for Appeal Hearing, Appeal Pre-Filing Form	1596 kB
Background Check position screening	106 kB
Workplace Violence Statement Form	133 kB
Conflict of Interest - Salt Lake County Disclosure Statement	309 kB

Employee Relations- ADA

Employee Relations- ADA
File	Size
ADA Intake Form	110 kB
ADA HIPAA Form	64 kB
ADA Interactive Process Worksheet (for Agency use only)	88 kB
ADA Medical Information Questionnaire	1597 kB

Employees' University

Employees' University
File	Size
Software Training Agreement	380 kB
Tuition Reimbursement Application	294 kB

Family Medical Leave (FMLA)

Family Medical Leave (FMLA)
File	Size
Covered Service Member Health Condition	203 kB
Designation Notice - FMLA	189 kB
Employee's Serious Health Condition	247 kB
Family's Serious Health Condition	199 kB
Family Medical Leave Request Form	250 kB
Military Family Leave Qualifying Exigency	164 kB
Notice of Eligibility- Rights and Responsibilities - FMLA	310 kB

Pay Policy Forms

Pay Policy Forms
File	Size
Bonus Award Letter-Example	41 kB
Incentive Plan	144 kB
In-Grade Advancement Plan	202 kB
Salary Recommendation Form	547 kB

Payroll and New Hire

Payroll and New Hire
File	Size
Acting in Position Agreement	218 kB
Criminal Records Name Check and Fingerprint Check Waiver	228 kB
Criminal Records Billing	199 kB
ePar Action - Reason Grid	154 kB
ePar Access Request	206 kB
ePar Deadlines 2022	387 kB
Form I-9 Employment Eligibility Verification (Spanish) - HR Use Only	326 kB
Mileage Reimbursement	69 kB
New Hire Information - Temporary	143 kB
Time Limited Appointment Contract	86 kB
On-Call and Call Back Pay	225 kB
Overtime Compensation Agreement Form	160 kB
Payroll Access Form	191 kB
Release of Information Form-49 CFR Part 40 Drug and Alcohol Testing For FMCSA RegulatedEmployers	15 kB
Snow Removal Agreement	166 kB
Utah Retirement Systems Leave Notification (MELV-2)	81 kB
Workflow Approval List	233 kB
Workflow Form	832 kB
New Hire Information – Appointed /Elected /Time-Limited	145 kB
New Hire Information – Merit/Sworn	146 kB
ePAR Guide Approver Instructions	178 kB
ePAR Guide Initiator Instructions	205 kB
ePAR FAQs	77 kB
W-4, Current Year	173 kB
Internship Agreement Form	180 kB

Performance and Development

Performance and Development
File	Size
COVID-Supplemental PDP for Redployed/Reassigned Employees	220 kB
Performance Improvement Plan	56 kB
Performance Plan and Appraisal	1435 kB
Pro-Rate Annual Appraisal Calculation	1593 kB

Recruitment

Recruitment
File	Size
ADP/Recruiting Management Access	149 kB
ADP RequisitionTraining	3444 kB
Reference Release	290 kB
Template for Reference Check Questions	430 kB