Internal Use Forms

For additional human resources forms, see the New Employee Orientation Forms and Exit Interview Forms pages.

Pay, Leave and Performance-Related Forms

If the form is in a format other than a PDF file, save it to your computer before you begin to fill it out.

• Performance Form (Word, 76 KB)
• Pre-Performance Evaluation Worksheet (Word, 26 KB)
• Student Employment Authorization (Excel, 25 KB)
• Student Monthly Time Record (Excel, 22.5 KB) -- this form must be printed on blue paper
• Staff Monthly Time Record (Excel, 24.5 KB)
• Request and Authorization for Leave of Absence (Excel, 25.5 KB)
• Faculty Leave Form (PDF, 129 KB)
• Direct Deposit Form (PDF, 19.4 KB)
• Employee Registration Fee Waiver/Tuition Payment (PDF, 15.1 KB)
• BAR-SR-BAR Employee Excellence Award Nomination Form (Word, 24.5 KB)
• Temporary Employment (Word, 47 KB)
• Applicant Interview Form (Word, 43 KB)
• Verification of Candidate Qualification (Word, 28 KB)

Optional Retirement Program and Tax Sheltered Annuity Notices and Forms

• TSUS Optional Retirement Program Plan (PDF, 101 KB)
• TSUS Supplemental Tax-Sheltered Annuity Plan (PDF, 132 KB)
• ORP and Tax-Sheltered Annuity Notice to Employee on 415 Contribution Limits (PDF, 51.3 KB)
• Overview of Teacher Retirement System of Texas and ORP (PDF, 170 KB)
• Notification of Employee Responsibilities Under Texas ORP (PDF, 13.3 KB)
• Solicitation Practices for Optional Retirement and Tax Sheltered Annuity Programs (PDF, 5.6 KB)
• SRSU-Approved ORP and Tax-Sheltered Annuity Vendors (PDF, 11.8 KB)
• Notice of Election to Participate in Optional Retirement Program (PDF)
• Texas ORP Prior Participation Certification Form (PDF, 35.1 KB)
• ORP and Tax Shelter Annuity Salary Reduction or Change of Company (PDF, 17.5 KB)
• ORP and Tax Shelter Annuity Capital Transfer Form (PDF, 12.6 KB)

Insurance Forms

These forms are hosted and maintained by the Employee Retirement System and medical/insurance company web sites.

• Blue Cross and Blue Shield HealthSelect Claim Form (PDF)
• Caremark's Website (PDF)
• Caremark Mail Service Order Form (PDF)
• Caremark Preferred Drug List (PDF)
• GEHA Dental Claim Form (PDF)
• Aetna/Prudential DMO Dentist Selection Form (PDF)
• Insurance Multipurpose Form (PDF)
• Insurance Supplemental Information Form (PDF)
• Evidence of Insurability Form (PDF)
• State Kids Insurance Program (SKIP) Instructions and Application Form (PDF)
• TexFlex Enrollment Form (PDF)
• TexFlex Reimbursement Request Form and Instructions (PDF)
• TexFlex Tax Calculator (PDF)

Teacher Retirement Forms

These forms are hosted and maintained by the Teacher Retirement System web site.

• Teacher Retirement Designation of Beneficiary Form (PDF)
• Teacher Retirement Notice of Final Deposit and Request for Refund Form (PDF)
• Teacher Retirement Request for Estimate of Retirement Benefits Electronic Form (PDF)
• Teacher Retirement Request for Estimate of Retirement Benefits Manuel Form (PDF)
• Teacher Retirement Change of Address Notification (PDF)

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