Forms

Below is a sortable table of forms required by University Human Resources (UHR) for the many programs and services available to University of Maryland College Park employees.  If you have a question about how to fill out or the use of a form, please contact the respective office or by email at UHRConnect@umd.edu.

*Open PDF forms in Adobe Acrobat to enable fillable form features disabled when viewing PDF in a browsers.  If you do not have Adobe Acrobat, it is available from Terpware under Design & Production

Use the search box to narrow the listing of forms or use the drop down filters to view forms by a specific department or type.

OfficeTypeFormDownload
BenefitsHealthBenefits Guide Book 2016Online
BenefitsHealthDirect Pay Health Benefits Enrollment Form
BenefitsHealthContractual Health Benefits Enrollment Form
BenefitsHealthDisabled Dependent Certification
BenefitsHealthHealth Insurance Portability & Accountability Act (HIPAA)
BenefitsHealthRegular Status Health Benefits Enrollment Form
BenefitsHealthRetiree Health Benefits Enrollment
BenefitsHealthAddress/Name ChangeOnline
BenefitsHealthAffidavit Dependent Eligibility Tax Status
BenefitsHealthContract Appointment Renewal
BenefitsHealthNotification of Termination for Benefits
BenefitsTuition RemissionSubmit Tuition RemissionOnline
BenefitsFlexible Spending Account (FSA)Connect Your Care (Dependent Claim Form)
BenefitsFlexible Spending Account (FSA)Connect Your Care (Health Claim Form)
BenefitsState Retirement Pension (SRP)Pension Enrollment Form (Faculty / Exempt)
BenefitsState Retirement Pension (SRP)Pension Enrollment Form (Nonexempt)
BenefitsState Retirement Pension (SRP)Pension Pre-Retirement Checklist
BenefitsSupplemental Retirement Annuity (SRA)Maryland Supplemental Retirement Plans 401 / 457b / 403b Rollover FormOnline
BenefitsSupplemental Retirement Annuity (SRA)457b TIAA-CREF (SRA) Enrollment / Deduction Change Form
BenefitsSupplemental Retirement Annuity (SRA)Maryland Supplemental Retirement Plan 401k / 457b / 403b Change FormOnline
BenefitsSupplemental Retirement Annuity (SRA)Maryland Supplemental Retirement Plan 401k / 457b / 403b Enrollment FormOnline
BenefitsSupplemental Retirement Annuity (SRA)403b Fidelity (SRA) Enrollment / Deduction Change Form
BenefitsSupplemental Retirement Annuity (SRA)403b TIAA CREF (SRA) Enrollment / Deduction Change Form
BenefitsSupplemental Retirement Annuity (SRA)457b Fidelity (SRA) Enrollment / Deduction Change Form
BenefitsOptional Retirement Program (ORP)ORP Enrollment Forms
BenefitsOptional Retirement Program (ORP)Checklist of ORP Pre-Retirement Action Items
BenefitsLife/DisabilityUnum Life - LTD Enrollment
BenefitsLife/DisabilityUnum LTD Highlight Sheet
BenefitsLife/DisabilityUnum LTD Evidence of Insurability
BenefitsLife/DisabilityUnum LTD Claim
BenefitsLife/DisabilityUnum Life Coverage Highlights
BenefitsLife/DisabilityUnum Life Beneficiary
BenefitsLife/DisabilityMinnesota Life Evidence of Insurability
BenefitsLife/DisabilityMinnesota Life Beneficiary Designation
Employment - CompensationActing/Administrative Request Form
Employment - Compensation Employment ContractContingent I (Health Benefits Eligible)
Employment - CompensationEmployment ContractContingent I (Not Eligible for Health Benefits)
Employment - CompensationEmployment ContractContingent II Nonexempt (Health Benefits Eligible)
Employment - CompensationEmployment ContractContingent II Nonexempt (Not Eligible for Health Benefits)
Employment - CompensationEmployment ContractContingent II Exempt (Health Benefits Eligible)
Employment - CompensationEmployment ContractContingent II Exempt (Not Eligible for Health Benefits)
Employment - CompensationE-Verify FormOnline
Employment - CompensationManager's ToolkitOnline
Employment - CompensationStaff Overload Authorization (Teaching)
Employment - CompensationStaff Overload Authorization (Non-Teaching)
Employment - CompensationPosition Description Form
Employment - CompensationSalary Increase Approval
Employment - CompensationStudent Wage Exemption Form
Information ServicesThe 3 D's List RequestOnline
Information ServicesInstructions for Employees with Prior State ServiceOnline
Information ServicesEmployee Designee Affiliate Information FormOnline
Information ServicesPHR Data Request FormOnline
Information ServicesMailing Label Request FormOnline
Information ServicesPHR Data Warehouse Client Training RegistrationOnline
Information ServicesUM Data Warehouse Account Request FormOnline
PayrollFormAddress/Name ChangeOnline
PayrollFormPay Advance & Recovery Form
PayrollFormApplication for Social Security CardOnline
PayrollFormDirect Deposit
PayrollFormNRA ResourcesOnline
PayrollFormW-4 Employee Withholding AllowanceOnline
PayrollFormI-9
Staff RelationsPRDPRD FormsClick Here
Staff RelationsLeaveAdvanced Sick LeaveOnline
Staff RelationsLeaveAdvanced Annual Leave
Staff RelationsLeaveExtended Sick Leave
Staff RelationsLeaveFaculty Leave InformationOnline
Staff RelationsLeaveFamily and Medical LeaveOnline
Staff RelationsLeaveLeave Reserve Fund Request
Staff RelationsLeaveLeave Without Pay
Staff RelationsLeaveMilitary Leave Recording Procedures
Staff RelationsLeaveStaff Parental LeaveOnline
Staff RelationsADA Accommodation Request
Staff RelationsGrievance Form
Staff RelationsDisciplinary Suspension Form
Staff RelationsImmediate Termination of Access Form - Involuntary SeparationOnline