Forms

2024 Pathways Guide

UK Elder Care is pleased to present the 2014 Lunch & Learn Series. Bring your lunch and learn about important topics. Each free session requires preregistration and is open to UK faculty, staff, retirees, spouses, and sponsored dependents. Space is limited. Use the online form to register.

Thank you for your interest in receiving Caregiving Resources via the UK Elder Care Office.  

Please complete the form.

2024 STEPS Payroll Schedule

Direct deposit is mandatory for all UK employees. New Student employees should fill out this direct deposit form, attach a voided check and return to the department of hire. Completed direct deposit forms may also be sent directly to:

UK Payroll
340 Peterson Service Bldg.
0005

Departments/supervisors should complete this form when an employee leaves employment with the university.

For UK HealthCare voluntary employee separations, please submit a request through UK HealthCare Position Review. Involuntary separations should be submitted on the Employee Separations Sheet Form. If you have questions about this process or need support facilitating a UK HealthCare employee separation, please contact your HR Business Partner. 

Change your permanent address online using myUK, or submit the PDF form.

Use this form for any name change(s). Note: The employee completes the form with the appropriate change. Then, employee takes form to HR Benefits Office for entering into SAP. HR Benefits Office enters change into SAP. HR Benefits Office then forwards form to Compensation. Compensation will forward form to Employee Records after processing, where the copy will be filed in the individual’s Employee Record File. To change home and work addresses, go to myUK at https://myuk.uky.edu and update using the Employee Self Service (ESS) portal.

For UK employees only. Authorize an individual to contact the HR Benefits office and receive information regarding UK benefits on employee’s behalf.

Write a list of everything you would like to do from most important to least important. When you get extra money from any source, apply it to these goals. Item one may be new clothes for $100, item two could be a weekend trip away for $300, and item three could be pay off a credit card for $800. If you receive a $600 tax refund, you could do the first two items and put the remaining $200 towards the credit card debt.

More than a budget, this will help plan what bills will be paid with each paycheck.

This form can give you a game plan to pay off your debt. List debts from smallest to largest, pay as much as you can on the smallest and the minimum on the rest.  As one debt is paid off, add the amount you were paying monthly on that debt to the minimum payment on the next debt on the list.

Employees should complete this form to make matching 403(b) retirement savings plan contributions to Fidelity Investments and designate beneficiaries.

Employees should complete this form to make voluntary 403(b) retirement savings plan contributions to Fidelity Investments and designate beneficiaries.

Employees should complete this form to enroll in voluntary 457(b) retirement savings plan through Fidelity. This form is also used for designating a beneficiary.

This worksheet will give you a good basic understanding of what your current income and expenses really are.

Complete this form to authorize payroll deductions as contributions to UK's Matching Retirement Savings Plan.

This form allows staff or faculty of UK to enter a Phased Retirement process.

Employees should complete this form to make matching 403(b) retirement savings plan contributions to TIAA and designate beneficiaries.

Employees should complete this form to make voluntary 403(b) retirement savings plan contributions to TIAA Investments and designate beneficiaries.

Employees should complete this form to enroll in voluntary 457(b) retirement savings plan through TIAA. This form is also used for designating a beneficiary.

Use this form for additional voluntary contributions, over and above the standard 5 percent 403(b) employee contribution.

Use this form for voluntary contributions to a UK 457(b) retirement savings plan, separate from UK's 403(b) retirement plan.

This is a printer-friendly absence request form used for some University areas. Note: Main campus (non-UK HealthCare areas) now typically submit leave requests online through myUK Employee Self-Service. 

The Federal Drug-Free Workplace Act of 1988 (section 5151) requires that all employees receive a copy of the University's policy, which declares that UK is a drug-free workplace. This policy notification and this certification form insure the University's compliance with the federal law. 

Fill out and submit this form to enable automatic monthly payment of your UK Retiree Health Insurance premiums by bank draft (ACH).

Plan year July 1, 2023 through June 30, 2024



Retirees should use this form to enroll in health, dental and vision plans.

 

Plan year July 1, 2024 through June 30, 2025

Retirees should use this form to enroll in health, dental and vision plans.
 

Fill out and submit this form to defer retiree health coverage one time and have the option to return to university coverage in the future.

Use this form to manually submit a health insurance claim with Anthem.

Plan year July 1, 2023 through June 30, 2024



Use this form to enroll in COBRA insurance coverage, available to UK employees which allows you to continue your group health, dental and vision insurance on an individual basis when you or your dependent(s) become ineligible for University benefits.

Plan year July 1, 2024 through June 30, 2025

Use this form to enroll in COBRA insurance coverage, available to UK employees which allows you to continue your group health, dental and vision insurance on an individual basis when you or your dependent(s) become ineligible for University benefits.

Plan year July 1, 2023 through June 30, 2024 Enroll in UK health, dental and vision insurance. Qualifying dependent children may be covered to age 26.  You must download and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.

Plan year July 1, 2024 through June 30, 2025 Enroll in UK health, dental and vision insurance. Qualifying dependent children may be covered to age 26.  You must download and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.

Plan year July 1, 2023 through June 30, 2024



Use this form at any time during the year to start, stop, increase, or decrease the amount you contribute to you HSA.

 

Plan year July 1, 2024 through June 30, 2025

Use this form at any time during the year to start, stop, increase, or decrease the amount you contribute to you HSA.
 

Plan year July 1, 2023 through June 30, 2024



Use this form if you are enrolling in the UK Saver HSA health plan and would like to make additional employee contributions. This also includes the option to open a limited flexible spending account. You must download the form and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.

 

Plan year July 1, 2024 through June 30, 2025

Use this form if you are enrolling in the UK Saver HSA health plan and would like to make additional employee contributions. This also includes the option to open a limited flexible spending account. You must download the form and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.
 

Candidate Interview Confirmation Email for On-Campus Interviews

Candidate Interview Confirmation Email for Phone/Skype Interviews

Candidate Not Selected Letter or Email

Conducting a Reference Check Checklist

Conducting the Interview Checklist for On-Campus Interviews

Conducting the Interview Checklist for Phone/Skype Interviews

Conversation Starters for Informal Interview Settings

Conversations for Scheduling an Interview

Do’s and Don’ts of Interviewing

Evaluation Rubric

Evaluation Templates for Candidates

Use this form to submit an online request for flexible work schedule. A copy of the submitted form goes to you, your supervisor, and the Director of WorkLife at UK. Together you will work out the best flexible workplace arrangement.

Hiring and Selection Timeline Overview

Interview Preparation Checklist for On-Campus Interviews

Interview Preparation Checklist for Phone/Skype Interviews

Offer Letter Checklist

On-Campus Candidate Feedback Survey

Sample Competencies and Interview Questions for Faculty Positions

Sample Job Postings

Use this form to evaluate new or transferred employees performance after 90 days of employment.

Hiring officials that are in the process of hiring anyone as it pertains to Policy 17.0: HR Temporary and Student Employment Services should fill out this form.

Position Description Checklist

Complete online form

At the conclusion of a STEPS temporary employee's assignment, please fill out this performance evaluation. It is important to us when considering future assignments for each employee. Please complete and return this form to the Temporary Employment office by faxing to 257-­7464 or send the original via campus mail to:

Temporary Employment, 2365 Harrodsburg Road, Building B, Suite B-175

Use this form to submit a request for posting a new Student Employee position.

If you have hired a Student Employee through UK, we want to know about it! Student Employment at the University of Kentucky is funded in part by a grant, which stipulates that we must collect hiring information. Please help us keep this great service FREE by supplying the following information when you have hired a Student Employment referral. Thank you.

Use this form to create a new position or redefine the duties of a current position. Once completed all required signatures must be obtained prior to submitting the document to the Compensation Department.

This form allows UK Employees to apply for the Employer Assisted Housing Program.

This map outlines the area surrounding UK that defines the boundaries of the UK Employee Assisted Housing Program.

As a UK employee, you have the opportunity to enroll a family member in the Family Education Program through UK.

Plan year July 1, 2023 through June 30, 2024

Use this form to enroll in health and/or dependent care flexible spending accounts (FSA). You must download the form and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.

Plan year July 1, 2024 through June 30, 2025

Use this form to enroll in health and/or dependent care flexible spending accounts (FSA). You must download the form and save it to your computer to complete the digital signature. Viewing the form in a web browser will not allow a digital signature.

Use this form to manually submit a flexible spending account claim with ASI Flex.

Click here to complete form 

Use this form to name your beneficiaries for your optional life insurance and optional accidental death & dismemberment insurance.

Plan year July 1, 2023 through June 30, 2024 Use this form to enroll in additional life insurance coverage for yourself, spouse/sponsored dependent, or children. Qualifying dependent children may be covered to age 26.  This form also allows you to enroll in separate accidental death & dismemberment insurance.  

Plan year July 1, 2024 through June 30, 2025 Use this form to enroll in additional life insurance coverage for yourself, spouse/sponsored dependent, or children. Qualifying dependent children may be covered to age 26.  This form also allows you to enroll in separate accidental death & dismemberment insurance.  

Plan year July 1, 2023 through June 30, 2024



Use this form to enroll in legal services insurance or cancel it.

 

Plan year July 1, 2024 through June 30, 2025

Use this form to enroll in legal services insurance or cancel it.
 

This form allows enrolled participants in the Employee Education Program to request a one-time exemption from the semester limit to the number of hours an employee can take.

This form is for use by students who are also employed by the University of Kentucky as regular employees using the tuition waiver benefit to attend other Kentucky state-funded institutions. Students who wish to use the tuition waiver benefit must release their academic records in order for University of Kentucky Human Resources to receive academic records from these other Kentucky public institutions. The information is for internal use only, related to benefit eligibility and administration and will not be shared with any parties outside of the University of Kentucky.

This fillable form allows UK Employees to enroll in the Employee Education Program (EEP) at UK.

For permission to release UK employee file information or to apply for rehire consideration, use this form.  Please complete one form per request.  Email to employeerecords@uky.edu.

To release salary information for verifications of employment (VOE), use this form. The information cannot be provided until this form (or that of the requesting organization) has been signed and submitted. Note that businesses and non-government agencies will also be required to pre-pay a $30 fee, and a VOE cannot be completed until confirmation that the fee has been paid. You can email this form to verifications@uky.edu or fax to (859) 257-8514.

Use this form to create new organizational units and to change existing information concerning organizational units in SAP

If you do not qualify for Family Medical Leave, use this form to request one week of paid elder care leave.

If you do not qualify for Family Medical Leave, use this form to request two weeks of paid parental leave.

Use this form to change the position reporting information in SAP.

Contact (859) 257-8758 for more information.

The exit interview is an opportunity to obtain valuable information about perceptions, frustrations and areas in need of improvement. The Exit Interview Survey is designed to gather information in a consistent, non-threatening manner. Although written in survey format, each department is encouraged to identify a neutral third party to meet one on one with the employee and gather information orally. The exit interview is voluntary but strongly encouraged.

Use this form when an employee is being placed in an approved flex leave position. This form should be forwarded to the Compensation Department along with the PAR prior to the employee being placed on flex leave.

This form must be completed by department administrators prior to retaining any individual to provide services and submitted to HR as explained in BPM E-7-3.

Click here

Form to be completed for approval of assignment outside exempt employee's main department/work assignment.

This is a paper version of the official form which resides in IES. Use this as a tool to pass around within your department while editing it. Then once a final version is completed, it can be entered into IES (Position Management).

NOTE: If you are wanting to use digital signatures, please open/download the file in Adobe Acrobat.

Submit forms to Lindsey Powell by emailing lindseyhpowell@uky.edu or faxing to 859-257-2010.

Request for Family and Medical Leave - Serious injury or illness of current servicemember for Military Family Leave

Request for Family and Medical Leave - Qualifying Exigency for Military Family Leave

By signing this form, you acknowledge you understand graduate-level tuition waivers above $5,250 in a calendar year must be reported as income and are subject to taxation, per Section 127 of the Internal Revenue Code.

Use this form to apply for free rental of a breastpump from Grogan's Medical Supply, as part of UK's support of lactation in the workplace.

Printable guide for UK parents preparing for leave, finding child care, support offered by UK and everything you need to know about Family Medical Leave.

Under some circumstances it may be necessary to manually file a prescription claim.  For example if you are out of town and cannot locate your Express Scripts ID card, it may be necessary to pay for the prescription and manually file for reimbursement once you return. 

Please note claims must be filed within twelve (12) months of receiving a prescription.

Under some circumstances it may be necessary to manually file a prescription claim.  For example if you are out of town and cannot locate your Express Scripts ID card, it may be necessary to pay for the prescription and manually file for reimbursement once you return. 

Please note claims must be filed within twelve (12) months of receiving a prescription.

Prescription formularies for UK health plan members on either HMO, PPO, RHP, EPO, Saver or Indemnity plans.



If you have any questions, call our pharmacists with the Know Your Rx Coalition at (859) 218-5979 or (855) 218-5979 for information specific to your medication, formulary and costs.

This form allows UK Staff to apply for use of the Staff Shared Leave Pool allocation.

Student Employment at the University of Kentucky is funded in part by a grant, which stipulates that we must collect hiring information. Please help us keep this great service FREE by supplying the information when you are hired.

This intake form will provide the Career Development office with the preliminary information they need to better assist you for your Career Develompent appointment.