Forms may be accessed from this index. You may sort the table by Index, Title, Owner, Published, or Format by clicking on the table headings. Content displayed may be refined by using the column filters located underneath the column titles.

Listings of Retired Forms and Exhibits maybe be found in the disposition table.

Index
Title
Owner
Published
Format
1-1 Departmental Payroll Voucher Payroll Services 10/10/2008 PDF
1-2 Check Distribution and Change of Address Payroll/Accounting 10/10/2008 PDF
1-5A Monthly Employee Time Record Payroll Services 08/29/2011 PDF
1-5B Hourly Employee Time Record Payroll Services 08/29/2011 PDF
1-5C Time Record Codes Payroll Services 05/16/2007 PDF
1-6 Departmental Vacation/Holiday Payroll Voucher Payroll Services 06/11/2007 PDF
1-7 Salary Spread Request Payroll Services 05/10/2008 PDF
1-8A Authorization for Professional Services Payroll/Accounting 03/03/2011 PDF
1-8B Authorization for Professional Services (Less than $600) Payroll Services 03/07/2011 PDF
1-8C Statement for Foreign National Honoraria Recipients Payroll Services 02/23/2011 PDF
1-9 Payee Information Form Payroll/Accounting 04/07/2010 PDF
1-18 Request for Taxpayer Identification Number and Certification Payroll Services 09/24/2008 PDF
1-19 W-4 Employee's Withholding Allowance Certificate Payroll/IRS 03/23/2006 PDF
2-1 Account Profile & Request for New Account Accounting Services 02/09/2009 PDF
2-2 Custodian and Working Fund Authorization Accounting Services 02/09/2009 PDF
2-5 Texas Sales and Use Tax Exemption Certification Accounting Services 07/05/2007 PDF
2-6 Payment Approval Voucher Accounting Services 06/18/2007 PDF
2-7 Departmental Deposit Accounting Services 06/18/2007 PDF
2-8 Restrictive Payee Stamp Accounting Services 06/18/2007 PDF
2-9 Restrictive Endorsement Stamp Accounting Services 06/18/2007 PDF
2-10 Daily Check Log Accounting Services 06/18/2007 PDF
2-11 Cash Receipt Accounting Services 06/18/2007 PDF
2-12 Statement of Accounts Reconciliation & Acknowledgement Accounting Services 06/18/2007 PDF
2-13 Direct Deposit Form Accounting/Bursar 07/24/2009 PDF
2-26 Justification and Pro Forma Budget Student Financial Services 09/11/2007 EXCEL
2-30 Account Authorization Request Form & Instructions DEFINE 12/02/2008 PDF
2-31 Dean-VP Routing Form & Instructions DEFINE 12/02/2008 PDF
2-32 *DEFINE User Setup & Instructions DEFINE 12/02/2008 PDF
2-34 Electronic Signature Authorization Request DEFINE 12/02/2008 PDF
2-45 Inventory Transaction Form Asset Management 09/08/2010 PDF
2-47 Removal of Equipment from University Campus Asset Management 01/01/1998 PDF
2-48 Central Receiving Work Request Form Asset Management 07/01/2007 PDF
2-49 Asset Information Form Asset Management 08/05/2009 PDF
2-50 Document Destruction Request Form Asset Management 08/11/2011 PDF
2-60 Application for Nurse Faculty Exemption Student Financial Services 04/10/2008 PDF
2-61 Application for Preceptor Exemption Student Financial Services 04/10/2008 PDF
2-62 Nurse Faculty Loan Form Student Financial Services 04/10/2008 PDF
2-63 Perkins Loan Repayment Form Student Financial Services 04/10/2008 PDF
2-65 Application for Tuition Exemption per TEC 54.208 Peace Officer Enrolled in Criminal Justice Course/s Student Financial Services 08/04/2011 PDF
2-91 Request for Travel Authorization Travel 09/06/2007 PDF
2-92 Travel Voucher Travel 07/01/2011 PDF
2-93 Travel Advance Voucher Travel 06/15/2007 PDF
2-94 Texas Sales and Use Tax Exemption Certification Travel 07/06/2009 PDF
2-95 Texas Hotel Occupancy Tax Exemption Certificate Travel 12/08/2004 PDF
2-96 Non-Overnight Mileage Detailed Report Travel 07/01/2011 PDF
2-97 Travel Voucher Cover Sheet for Multiple Accts Travel 06/15/2007 PDF
2-98 Official Occasion Expense Form Travel 06/06/2009 PDF
2-100 Travel Voucher Cover Sheet Travel 11/19/2007 PDF
2-103A Traveler Profile - Carlson Wagonlit Travel 07/20/2011 PDF
2-103B Traveler Profile - Corporate Travel Planners Travel 07/20/2011 PDF
3-3 Personnel Action Form Human Resources 05/10/2008 PDF
3-5 Record of FLSA (Overtime) Compensation Time Earned and Taken Human Resources 03/05/2008 PDF
3-7 Form I-9, Employment Eligibility Verification Human Resources 02/02/2009 PDF
3-8 Notice of Voluntary Service Human Resources 03/05/2008 PDF
3-9 Criminal Background Check Human Resources 05/28/2008 PDF
3-15 Appeal of Disciplinary Action - First Step Human Resources 12/01/2000 PDF
3-15A Disciplinary Action Appeal - Continuation Human Resources 12/01/2000 PDF
3-16 Employee Clearance Human Resources 03/10/2011 PDF
3-18 Sick Leave Pool Application Human Resources 01/19/2005 PDF
3-19 Outside Employment Human Resources 11/04/2009 WEB
3-23 Family Medical Leave Application Human Resources 03/03/2009 PDF
3-26 High School Student - Position Information and Application Human Resources 07/21/2011 PDF
3-27A New Employee Packet Human Resources 12/22/2011 PDF
3-27B Instructions for Employee Packet Human Resources 07/17/2007 PDF
3-28 Employee Insurance Enrollment Application Human Resources 08/13/2010 PDF
3-30 Benefits Cost Worksheet Human Resources 10/07/2010 PDF
3-33 Coverage for Incapacitated Child Form Human Resources 07/10/2007 PDF
3-34 Medco Pharmacy Home Delivery Order Form (UT Select) Human Resources 07/10/2007 PDF
3-35 Medco Prescription Drug Claim Form (UT Select) Human Resources 07/10/2007 PDF
3-36 Transitional Benefits Form Human Resources 07/10/2007 PDF
3-37 UT Select Dental Claim Form Human Resources 07/10/2007 PDF
3-38 Superior Vision Provider Nomination Human Resources 07/10/2007 PDF
3-39 UT FLEX Claim Form Human Resources 07/10/2007 PDF
3-40 UT FLEX Direct Deposit Form Human Resources 07/10/2007 PDF
3-41 UT FLEX Letter of Medical Necessity Human Resources 07/10/2007 PDF
3-42 Fort Dearborn Term Life Beneficiary Designation Human Resources 07/10/2007 PDF
3-44 Notice of Creditable Coverage for Medicare Part D Human Resources 07/10/2007 PDF
3-45 TRS Form 6 (Notice of Final Deposit and Request for Refund) Human Resources 07/10/2007 PDF
3-46 TRS Form 18 (Request for Estimate of Retirement Benefits) Human Resources 07/10/2007 WEB
3-47 Transfer Verification Form Human Resources 07/10/2007 PDF
3-48 TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program) Human Resources 07/10/2007 PDF
3-49 TRS Form 29 (Application for Refund) Human Resources 07/10/2007 PDF
3-50 Authorization for Reduction for Employee Contributions Human Resources 07/10/2007 PDF
3-51 Authorization for Reduction for Employee Contributions for Employees returning to ORP Human Resources 07/10/2007 PDF
3-52 ORP Acknowledgement Form Human Resources 07/10/2007 PDF
3-53 Optional Retirement Program (ORP) Retirement Certification Form Human Resources 07/10/2007 PDF
3-54 Tax-Sheltered Annuity Disclosure Human Resources 07/10/2007 PDF
3-55 Purchase Change Agreement Human Resources 07/10/2007 PDF
3-56 Special Catch-Up Provision Disclosure Human Resources 07/10/2007 PDF
3-57 Short Term Disability Highlights Human Resources 01/07/2010 PDF
3-58 Long Term Care Brochure Human Resources 07/10/2007 PDF
3-59 Continuation Coverage Notice Human Resources 08/13/2010 PDF
3-60 HIPAA Privacy Information Human Resources 07/10/2007 WEB
3-61 Accidental Death and Dismemberment Benefits Guide Human Resources 07/10/2007 PDF
3-62 Assurant Dental HMO Benefits Guide Human Resources 07/10/2007 PDF
3-63 UT System Group Benefit Handbook for Employees Human Resources 10/07/2010 PDF
3-64 Group Term Life Benefits Guide Human Resources 07/10/2007 PDF
3-66 Long Term Disability Benefits Guide Human Resources 07/10/2007 PDF
3-67 Short Term Disability Benefits Guide Human Resources 07/10/2007 PDF
3-68 Superior Vision Benefits Guide Human Resources 07/10/2007 PDF
3-69 Teachers Retirement System (TRS) Handbook Human Resources 07/10/2007 PDF
3-70 UT FLEX Benefits Guide Human Resources 07/10/2007 PDF
3-71 UT Select Benefits Guide Human Resources 07/10/2007 PDF
3-72 UT Select Dental Benefits Guide Human Resources 07/10/2007 PDF
3-73 UT System Group Benefits Handbook for Retirees Human Resources 10/07/2010 PDF
3-74 UT System Retirement Programs Guide Human Resources 07/10/2007 WEB
3-75 Exit Interview Questionnaire Human Resources 07/28/2010 WEB
3-76 Quest Release Time Form Human Resources 05/10/2008 PDF
3-77 Employee Tuition Certification Form Human Resources 07/01/2009 PDF
3-78 Classified Staff Evaluation Form - Narrative Format Human Resources 01/21/2011 PDF
3-79 Employee Self-Evaluation Form Human Resources 01/21/2011 PDF
3-80 Administrative and Professional Form Human Resources 01/21/2011 PDF
3-81 Classified Staff Evaluation Form - Check Box Format Human Resources 01/21/2011 PDF
3-82 Performance Management Forms Human Resources 01/21/2011 PDF
3-83 Performance Management Form for New Employees Human Resources 01/21/2011 PDF
3-84 Sample Reference Check Form Human Resources 03/23/2009 PDF
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources 10/12/2011 PDF
3-86 Flexible Work Arrangement Agreement Human Resources 03/10/2010 PDF
3-87 Telecommuting Agreement Human Resources 02/12/2010 PDF
3-201 Personal Information Form Human Resources 06/01/2010 PDF
3-202 State Employment Verification Form Human Resources 03/04/2008 PDF
3-203 Selective Service Registration Verification Form Human Resources 03/04/2008 PDF
3-204 Sick Leave Pool Contribution Form Human Resources 11/11/2009 PDF
3-205 Financial Disclosure and Conflicts of Interest Human Resources 04/26/2010 WEB
3-206 Outstanding Maverick Award Nomination Form Human Resources 10/19/2011 PDF
4-1 Request to Purchase - Standard Request Procurement 02/03/2012 PDF
4-2 Request to Purchase (Sample) - Split Accounts Procurement 09/11/2007 PDF
4-3 Request to Purchase (Sample) - Confirm Request Procurement 09/11/2007 PDF
4-4 Purchasing Card Reconciliation Log and Example Procurement 04/06/2009 PDF
4-5 Purchasing Card Transaction Log and Example Procurement 04/06/2009 PDF
4-8 Purchasing Card Application Procurement 08/30/2011 PDF
4-9 Wireless Communication Device Allowance Request Procurement 05/27/2009 PDF
4-10 Vendor Performance Form Procurement 06/25/2007 PDF
4-11 Cardholder Agreement Procurement 08/31/2011 PDF
4-13 Emergency Justification Procurement 02/22/2011 PDF
4-14 Sole-Source/Proprietary Justification for Services Procurement 02/22/2011 PDF
4-15 Sole-Source/Proprietary Justification for Goods Procurement 02/22/2011 PDF
4-16 Gift Certificate Expense Form Procurement 06/14/2007 PDF
4-17 Comdata Corporation Dispute Processing Form Procurement 04/18/2008 PDF
4-18 Summus/Staples Application Procurement 02/21/2008 PDF
4-19 eShipGlobal Access Request Form Procurement 04/19/2006 PDF
4-20 Vendor Direct Deposit / Advance Payment Notification Authorization Procurement 02/14/2011 PDF
5-4 Vehicle Request Form Facilities 03/18/2009 PDF
5-5 Operation of UTA 15-Passenger Vans Facilities 03/24/2006 PDF
6-1 GTA Parking Permit Decal Permission Police 07/25/2006 PDF
6-3 Key Request Police 08/30/2011 PDF
6-4 Lost or Missing University Report Form Police 08/24/2011 PDF
6-5 Lost Property Report Form Police 02/25/2011 PDF
7-1 Request to Host a Camp/Conference Conference Services 05/03/2011 PDF
7-2 Facility Insurance Agreement Conference Services 05/03/2011 PDF
7-3 Summer Conference Housing Reservation Request Conference Services 05/03/2011 PDF
7-4 Summer Conference Dining Request Conference Services 05/03/2011 PDF
7-5 Admissions Tours and Presentation Request Conference Services 05/03/2011 PDF
7-6 Health Services Summer Camp Fee IDT Conference Services 02/09/2012 PDF
7-8 Advance Planning (Cosmic) Calendar Reservation Request E.H. Hereford University Center 08/19/2011 PDF
7-9 Department Event Request E.H. Hereford University Center 02/16/2012 PDF
8-2 Supervisor's Report of Employee Work-Related Injury or Occupational Disease EH&S - WCI 11/02/2011 PDF
8-3 Supplemental Report of Injury EH&S - WCI 06/24/2008 PDF
8-4 Request for Paid Leave Due to On-The-Job Injury EH&S - WCI 10/01/2005 PDF
8-6 Employee's Report of Work-Related Injury or Occupational Disease EH&S - WCI 11/02/2011 PDF
8-9 Notification of Work-Related Injury or Occupational Disease EH&S - WCI 03/14/2011 PDF
8-10 Injured Employee Workers Compensation Guidelines EH&S - WCI 08/11/2010 PDF
8-11 Supervisors Workers' Compensation Checklist EH&S - WCI 08/11/2010 PDF
8-12 Workers Compensation Injury/Incident Witness Statement EH&S - WCI 08/11/2010 PDF
8-13 Ergonomic Evaluation Request EH&S - WCI 05/07/2008 PDF
8-14 myMatrixx First Fill Pharmacy Card EH&S - WCI 01/29/2010 PDF
8-15 Work Status Report and Instructions EH&S - WCI 02/01/2011 PDF
8-16 Workers Compensation Insurance Employee Request for Reimbursement of Medical Expenses EH&S - WCI 06/24/2008 PDF
8-17 Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease EH&S - WCI 06/24/2008 PDF
8-18 Notice of Fatal Injury or Occupational Disease and Claim for Compensation for Death Benefits EH&S - WCI 06/24/2008 PDF
8-19 Employee's Request to Change Treating Doctor - Non Network EH&S - WCI 06/24/2008 PDF
8-26 Laboratory Safety Evaluation (Biological) EH&S - Biological 08/08/2011 PDF
8-28 Request for Disposal Form - Biological Waste and Sharps EH&S - Biological 11/06/2009 PDF
8-29 Hepatitis B Vaccine Waiver EH&S - Biological 05/21/2008 PDF
8-30 Human Pathogen Registration (HPR) EH&S - Biological 08/04/2011 PDF
8-31 Human Pathogen Registration Update EH&S - Biological 11/06/2009 PDF
8-33 Autoclave Waste Treatment Log EH&S - Biological 11/02/2011 PDF
8-36 Laboratory Safety Evaluation EH&S - Chemical 08/08/2011 PDF
8-46 Hazard Reporting Form EH&S - DSL 04/10/2008 PDF
8-56 Application for Copy of Driver Record EH&S - Driving 07/26/2006 PDF
8-61 Hot Work Permit EH&S - Fire 04/10/2008 PDF
8-66 Lockout/Tagout Authorized Employee Training Form EH&S - Occupational 03/13/2006 PDF
8-67 Lockout/Tagout Request Form EH&S - Occupational 05/14/2008 PDF
8-68 Lockout/Tagout Master Index Form EH&S - Occupational 05/14/2008 PDF
8-69 Lockout/Tagout Periodic Inspection Form EH&S - Occupational 05/15/2008 PDF
8-70 First Aid Kit Request Form EH&S - Occupational 11/30/2011 PDF
8-71 IAQ Occupant Interview Form EH&S - Occupational 05/11/2006 PDF
8-72 Injury/Illness Reporting Form for Students & Visitors EH&S - Occupational 05/10/2008 PDF
8-73 Confined Spaces Entry Plan EH&S - Occupational 08/29/2011 PDF
8-74 Confined Spaces Inventory Form EH&S - Occupational 08/29/2011 PDF
8-81 Application to Use Radioactive Materials - sublicense EH&S - Radiation 05/10/2008 PDF
8-82 Request for Radiation Dosimeter Form EH&S - Radiation 05/10/2008 PDF
8-83 Request to Purchase Radioactive Materials Form EH&S - Radiation 05/10/2008 PDF
8-84A Radiation Safety Evaluation - Radioactive Materials EH&S - Radiation 05/10/2008 PDF
8-84B Radiation Safety Evaluation - X-Ray Producing Machines EH&S - Radiation 05/10/2008 PDF
8-84C Laser Safety Evaluation (Class 3b & 4 Lasers) EH&S - Radiation 08/04/2011 PDF
8-85 Pregnancy Declaration EH&S - Radiation 04/10/2008 PDF
8-86 Pregnancy Declaration Withdrawal EH&S - Radiation 04/10/2008 PDF
8-87 Biosafety Level 2 (BSL-2) Commissioning Checklist EH&S - Biological 02/09/2009 PDF
8-88 Laser Registration Form EH&S - Radiation 01/05/2012 PDF
9-1A Report of Medical History and Health Evaluation Health Services 09/20/2011 PDF
9-2 Financial Policy Health Services 09/14/2011 PDF
9-3 Authorization to Treat Minors Health Services 09/14/2011 PDF
9-4 Consent for Treatment of a Minor Who Does Not Have Legal Power to Consent Health Services 09/14/2011 PDF
9-5 Notice of Privacy Practices Health Services 01/06/2012 PDF
9-7 Authorization for the Use and Disclosure of Protected Health Information Health Services 09/14/2011 PDF
9-8 Authorization for the Use and Disclosure of Protected Health Information to Outside Entity Health Services 09/14/2011 PDF
12-1 Guest Apartment Reservation Request Guest Apartments 02/09/2012 PDF
13-1 Faculty or Staff Organization Registration Business Affairs and Controller 09/13/2011 PDF
13-4 Procedure Template Business Affairs and Controller 07/30/2010 WORD
13-5 Forms and Exhibits Template Business Affairs and Controller 01/27/2011 PDF
13-6 Records Disposition Log Records and Information Management 02/04/2009 PDF
13-7 Request for Authority to Dispose of Unscheduled University Records Records and Information Management 02/04/2009 PDF
13-8 Records Retention Schedule Departmental Records Amendment Records and Information Management 02/04/2009 PDF
13-9 Preliminary Summary Report of Tort Claims and Possible Tort Claims Business Affairs and Controller 08/25/2009 PDF
13-10 Records Retention Recertification and Survey Records and Information Management 03/08/2011 PDF
14-1 Photographic Consent and Release Form General 08/24/2011 PDF
15-10 Alcoholic Beverage Request Form Dining Services 10/04/2010 PDF
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations 08/06/2010 PDF
15-15 Release and Indemnification Agreement for Adult Students Administration and Campus Operations 08/06/2010 PDF
15-16 Release and Indemnification Agreement for Adults Administration and Campus Operations 08/06/2010 PDF
18-1 Encryption Exception Form Information Security Office 08/26/2011 PDF
19-1 Server Hosting Service Level Agreement Office of Information Technology 09/13/2011 PDF
20-1 Gift Records Form Accounting/Development 09/04/2010 PDF
20-2 UT Arlington Payroll Deduction Gift Form Payroll/Development 04/22/2008 PDF
21-1 Request for Disbursement of Scholarship/Fellowship Award Scholarships 01/12/2011 PDF
21-2 Scholarship Committee Chair Scholarships 06/09/2010 PDF
22-1 Complaint Form Equal Opportunity Services 04/01/2009 PDF
22-2 Request to Initiate H-1B Equal Opportunity Services 04/02/2009 PDF
22-3 H-1 Foreign Employee Questions Equal Opportunity Services 03/31/2009 PDF
22-4 Departmental Request to Initiate Legal Permanent Resident Equal Opportunity Services 07/23/2009 PDF
23-1 Life Safety Addendum Housing - Residence Hall 04/08/2009 PDF
23-2 Move-in Checklist Housing - Residence Hall 06/19/2009 PDF
23-3 Moving Checklist Housing - Residence Hall 04/08/2008 PDF
23-4 Roommate Agreement Housing - Residence Hall 04/08/2009 PDF
23-5 Transfer Application Packet Housing - Apartments 04/08/2009 PDF
23-6 Apartment Move In Guide Housing - Apartments 06/18/2009 PDF
23-7 Carpet Evaluation Request Housing - Apartments 04/08/2009 PDF
23-8 Cleaning and Sanitation Inspection Housing - Apartments 04/08/2009 PDF
23-9 Lease Assumption Application Packet Housing - Apartments 04/08/2009 PDF
23-10 Move Out Guide Housing - Apartments 04/08/2009 PDF
23-11 Occupant Termination Notice Housing - Apartments 04/08/2009 PDF
24-1 Handbook of Operating Procedures Policy Template Format Guidelines President's Office 01/05/2011 WORD