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
1-1 Departmental Payroll Voucher Payroll Services 06/25/2014
1-2 Check Distribution Payroll Services 05/05/2014
1-5A Monthly Employee Time Record Payroll Services 09/02/2014
1-5B Hourly Employee Time Record Payroll Services 09/02/2014
1-5C Weekly Employee Time Record Payroll Services 07/03/2014
1-5D Weekly Exempt Time Record Payroll Services 05/02/2014
1-6 Departmental Vacation/Holiday Payroll Voucher Payroll Services 05/05/2014
1-7 Salary Spread Request Payroll Services 05/05/2014
1-8A Authorization for Professional Services Payroll/Accounting 05/21/2014
1-8B Authorization for Professional Services (Less than $600) Payroll Services 05/05/2014
1-8C Statement for Foreign National Honoraria Recipients Payroll Services 02/23/2011
1-9 Payee Information Form Payroll/Accounting 04/07/2010
1-17 International Employees Only 
Request for GLACIER Password Payroll Services 02/16/2015
1-18 Request for Taxpayer Identification Number and Certification for Prizes, Awards, and Research Participants Payroll Services 03/28/2014
1-19 W-4 Employee's Withholding Allowance Certificate Payroll/IRS 03/23/2006
1-23 Employee Change of Address Payroll Services/Human Resources 05/05/2014
2-1 Request for New Cost Center Accounting Services 05/19/2014
2-2 Custodian and Working Fund Authorization Accounting Services 12/10/2014
2-5 Texas Sales and Use Tax Exemption Certification Accounting Services 04/16/2012
2-5B Texas Sales and Use Tax Exemption Certification for Amazon.com Accounting Services 06/27/2012
2-6 Payment Approval Voucher Accounting Services 04/30/2014
2-7 Departmental Deposit Accounting Services 04/21/2014
2-8 Restrictive Payee Stamp Accounting Services 06/18/2007
2-9 Restrictive Endorsement Stamp Accounting Services 06/18/2007
2-10 Daily Check Log Accounting Services 06/18/2007
2-11 Cash Receipt Accounting Services 06/18/2007
2-12 Statement of Accounts Reconciliation & Acknowledgement Accounting Services 10/20/2014
2-13 Direct Deposit Form Accounting/Bursar 07/24/2009
2-26 Justification and Pro Forma Budget Student Financial Services 09/11/2007
2-27 Initial Recharge Rate Request Accounting Services 04/25/2013
2-45 Inventory Transaction Form Property Management 03/09/2015
2-47 Removal of Equipment from University Campus Asset Management 06/04/2014
2-48 Work Request Form Property Management 02/12/2015
2-49 Asset Information Form Property Management 02/12/2015
2-50 Document Destruction Request Form Property Management 02/12/2015
2-60 Application for Nurse Faculty Exemption Student Financial Services 04/10/2008
2-61 Application for Preceptor Exemption Student Financial Services 04/10/2008
2-62 Nurse Faculty Loan Form Student Financial Services 04/10/2008
2-63 Perkins Loan Repayment Form Student Financial Services 04/10/2008
2-65 Application for Tuition Exemption per TEC 54.208 Peace Officer Enrolled in Criminal Justice Course/s Student Financial Services 08/04/2011
2-67 Waiver Appeal Student Financial Services 05/08/2015
2-95 Texas Hotel Occupancy Tax Exemption Certificate Travel 12/08/2004
2-96 Non-Overnight Mileage Detailed Report Travel 01/07/2015
2-98 Official Occasion Expense Form Travel 06/06/2009
2-100 Travel/Non-Travel Expense Cover Sheet Travel & Expense 06/26/2014
2-104 Non Employee Expense Reimbursement Travel 05/20/2014
3-3 Personnel Action Form Human Resources 04/30/2014
3-5 Record of FLSA (Overtime) Compensation Time Earned and Taken Human Resources 03/05/2008
3-7 Form I-9, Employment Eligibility Verification Human Resources 02/02/2009
3-8 Notice of Voluntary Service Human Resources 07/07/2014
3-9 Criminal Background Check Human Resources 10/27/2014
3-15 Appeal of Disciplinary Action - First Step Human Resources 12/01/2000
3-15A Disciplinary Action Appeal - Continuation Human Resources 12/01/2000
3-16 Employee Clearance Human Resources 01/13/2015
3-18 Sick Leave Pool Application Human Resources 07/07/2014
3-19 Conflict of interest, Conflict of Commitment and Outside Activities Human Resources 09/10/2014
3-23 Request for Family and Medical Leave Human Resources 07/07/2014
3-24 Return to Work Release Human Resources 02/27/2012
3-26 High School Student - Position Information and Application Human Resources 07/21/2011
3-27A New Employee Packet Human Resources 04/20/2015
3-27B Instructions for Completing New Employment Paper Work Human Resources 03/26/2013
3-28 Employee Insurance Enrollment Application Human Resources 05/20/2014
3-30 Benefits Cost Worksheet Human Resources 05/20/2014
3-33 Coverage for Incapacitated Child Form Human Resources 07/10/2007
3-34 Medco Pharmacy Home Delivery Order Form (UT Select) Human Resources 07/10/2007
3-35 Medco Prescription Drug Claim Form (UT Select) Human Resources 07/10/2007
3-36 Transitional Benefits Form Human Resources 07/10/2007
3-37 UT Select Dental Claim Form Human Resources 07/10/2007
3-38 Superior Vision Provider Nomination Human Resources 07/10/2007
3-39 UT FLEX Claim Form Human Resources 07/10/2007
3-40 UT FLEX Direct Deposit Form Human Resources 07/10/2007
3-41 UT FLEX Letter of Medical Necessity Human Resources 07/10/2007
3-42 Fort Dearborn Term Life Beneficiary Designation Human Resources 07/10/2007
3-44 Notice of Creditable Coverage for Medicare Part D Human Resources 07/10/2007
3-45 TRS Form 6 (Notice of Final Deposit and Request for Refund) Human Resources 07/10/2007
3-46 TRS Form 18 (Request for Estimate of Retirement Benefits) Human Resources 07/10/2007
3-47 Transfer Verification Form Human Resources 07/10/2007
3-48 TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program) Human Resources 07/10/2007
3-50 Authorization for Reduction for Employee Contributions Human Resources 05/20/2014
3-51 Authorization for Reduction for Employee Contributions for Employees returning to ORP Human Resources 05/20/2014
3-52 ORP Acknowledgement Form Human Resources 05/20/2014
3-53 Optional Retirement Program (ORP) Retirement Certification Form Human Resources 07/10/2007
3-54 Tax-Sheltered Annuity Disclosure Human Resources 07/10/2007
3-55 Purchase Change Agreement Human Resources 07/10/2007
3-56 Special Catch-Up Provision Disclosure Human Resources 07/10/2007
3-57 Short Term Disability Highlights Human Resources 01/07/2010
3-58 Long Term Care Brochure Human Resources 07/10/2007
3-59 Continuation Coverage Notice Human Resources 08/13/2010
3-60 HIPAA Privacy Information Human Resources 07/10/2007
3-61 Accidental Death and Dismemberment Benefits Guide Human Resources 07/10/2007
3-62 DeltaCare Benefits Guide Human Resources 05/20/2014
3-63 UT System Group Benefit Handbook for Employees Human Resources 05/20/2014
3-64 Group Term Life Benefits Guide Human Resources 07/10/2007
3-66 Long Term Disability Benefits Guide Human Resources 07/10/2007
3-67 Short Term Disability Benefits Guide Human Resources 07/10/2007
3-68 Superior Vision Benefits Guide Human Resources 05/20/2014
3-69 Teachers Retirement System (TRS) Handbook Human Resources 07/10/2007
3-70 UT FLEX Benefits Guide Human Resources 07/10/2007
3-71 UT Select Benefits Guide Human Resources 07/10/2007
3-72 UT Select Dental Benefits Guide Human Resources 07/10/2007
3-73 UT System Group Benefits Handbook for Retirees Human Resources 05/20/2014
3-74 UT System Retirement Programs Guide Human Resources 07/10/2007
3-75 Exit Interview Questionnaire Human Resources 07/28/2010
3-76 Quest Release Time Form Human Resources 02/27/2014
3-77 Employee Tuition Certification Form Human Resources 11/25/2014
3-78 Classified Staff Evaluation Form - Narrative Format Human Resources 07/07/2014
3-79 Employee Self-Evaluation Form Human Resources 07/07/2014
3-80 Administrative and Professional Form Human Resources 07/07/2014
3-81 Classified Staff Evaluation Form - Check Box Format Human Resources 03/26/2015
3-82 Performance Management Forms Human Resources 02/18/2015
3-83 Performance Management Form for New Employees Human Resources 07/07/2014
3-84 Sample Reference Check Form Human Resources 03/23/2009
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources 10/12/2011
3-86 Flexible Work Arrangement Agreement Human Resources 07/07/2014
3-87 Telecommuting Agreement Human Resources 07/07/2014
3-201 Personal Information Form Human Resources 03/11/2015
3-202 State Employment Verification Form Human Resources 02/17/2015
3-203 Selective Service Registration Verification Form Human Resources 02/18/2015
3-204 Sick Leave Pool Contribution Form Human Resources 07/07/2014
3-205 Financial Disclosure and Conflicts of Interest Human Resources 04/26/2010
3-206 Outstanding Maverick Award Nomination Form Human Resources 02/06/2015
3-207 Hiring Request Questions to Submit to Hiring Review Committee Human Resources 09/14/2012
4-4 Purchasing Card Carry Over Transaction Log and Example Procurement 05/06/2015
4-5 Purchasing Card Transaction Log and Example Procurement 05/06/2015
4-8 New Cardholder Account Form Procurement 09/29/2014
4-10 Vendor Performance Form Procurement 05/05/2014
4-11 Cardholder Agreement Procurement 02/05/2013
4-13 Emergency Justification Procurement 02/22/2011
4-14 Request for Sole Source Purchase (For Noncompetitive Purchases over $5000) Procurement 05/05/2014
4-14B Request for Sole Source Purchase - Template for Original Equipment Manufacturer (OEM) for Maintenance and Repair Procurement 05/05/2014
4-14C Request for Sole Source Purchase - Template for Software Maintenance Agreement with Original Licensor Procurement 05/05/2014
4-16 Gift Certificate Expense Form Procurement 05/05/2014
4-19 eShipGlobal Access Request Form Procurement 04/19/2006
4-20 Vendor Direct Deposit / Advance Payment Notification Authorization Procurement 02/14/2011
4-21 Vendor Supplier Information Procurement 05/08/2014
4-21B Vendor Supplier Information Instructions Procurement 05/08/2014
5-4 Vehicle Request Form Facilities 10/12/2012
5-5 Operation of UTA 15-Passenger Vans Facilities 03/24/2006
6-1 GTA Parking Permit Decal Permission Police 11/27/2012
6-3 Key Request Police 07/31/2013
6-4 Lost or Missing University Inventory Report Form Police 08/14/2012
6-5 Lost Property Report Form Police 02/25/2011
7-1 Request to Host a Camp/Conference Conference Services 10/09/2014
7-3 Summer Conference Housing Reservation Request Conference Services 12/01/2014
7-4 Summer Conference Dining Request Conference Services 12/01/2014
7-6 Health Services Summer Camp Fee IDT Conference Services 02/09/2012
7-8 Advance Planning (Cosmic) Calendar Reservation Request E.H. Hereford University Center 08/19/2011
7-9 Department Event Request University Center 08/13/2014
7-11 Event Change/Cancellation University Center 08/30/2012
7-12 External Reservation Form University Center 08/30/2012
8-2 Supervisor's Report of Employee Work-Related Injury or Occupational Disease EH&S - WCI 06/08/2012
8-6 Employee's Report of Work-Related Injury or Occupational Disease EH&S - WCI 12/20/2013
8-9 Notification of Work-Related Injury or Occupational Disease EH&S - WCI 02/27/2014
8-10A Injured Employee Workers Compensation Guidelines (English) EH&S - WCI 07/31/2013
8-10B Injured Employee Workers Compensation Guidelines (Spanish) EH&S - WCI 06/13/2013
8-10C Injured Employee Workers Compensation Guidelines (Vietnamese) EH&S - WCI 06/13/2013
8-11 Supervisors Workers' Compensation Checklist EH&S - WCI 08/06/2013
8-13 Ergonomic Evaluation Request EH&S - Occupational 05/07/2008
8-14 Workers’ Compensation Pharmacy Information EH&S - WCI 10/01/2013
8-20A Workers' Compensation Network Acknowledgement (English) EH&S - WCI 11/07/2014
8-20B Workers' Compensation Network Acknowledgement (Spanish) EH&S - WCI 04/01/2013
8-20C Workers' Compensation Network Acknowledgement (Vietnamese) EH&S - WCI 04/01/2013
8-21A Notice of Network Requirements for UT System (English) EH&S - WCI 11/07/2014
8-21B Notice of Network Requirements for UT System (Spanish) EH&S - WCI 04/01/2013
8-21C Notice of Network Requirements for UT System (Vietnamese) EH&S - WCI 04/01/2013
8-26 Laboratory Safety Evaluation (Biological) EH&S - Biological 09/16/2013
8-29 Hepatitis B Vaccine Waiver EH&S - Biological 11/04/2014
8-30 Human Pathogen Registration (HPR) EH&S - Biological 01/12/2015
8-31 Human Pathogen Registration Update (HPRU) EH&S - Biological 01/12/2015
8-32 Verification of Training for Work with Vaccinia Virus and Other Orthopoxviruses EH&S - Biological 02/03/2015
8-33 Autoclave Waste Treatment Log EH&S - Biological 12/05/2014
8-34 Hepatitis B Vaccination/Hepatitis B Vaccine Waiver/Exemption EH&S - Biological 09/16/2014
8-36 Laboratory Safety Evaluation EH&S - Chemical 08/08/2011
8-46 Hazard Reporting Form EH&S - DSL 12/10/2012
8-56 Application for Copy of Driver Record EH&S - Driving 07/26/2006
8-62 Charcoal and Propane Grill Permit EH&S - Fire 02/17/2014
8-63 Tent Permit Request Form EH&S - Fire 01/27/2014
8-64 Exchange of Lockout/Tagout Program EH&S - Occupational 03/20/2015
8-65 Energy Control Procedures EH&S - Occupational 02/16/2015
8-66 Lockout/Tagout Authorized Employee Form EH&S - Occupational 02/13/2015
8-70 First Aid Kit Request Form EH&S - Occupational 04/03/2015
8-71 IAQ Occupant Interview Form EH&S - Occupational 05/11/2006
8-72 Injury/Illness Reporting Form for Students & Visitors EH&S - Occupational 11/07/2013
8-73 Confined Spaces Entry Plan EH&S - Occupational 08/29/2011
8-74 Confined Spaces Inventory Form EH&S - Occupational 08/29/2011
8-75 Shop Safety Evaluation Checklist EH&S - Occupational 05/22/2014
8-77 Roof Access Request EH&S - Occupational 07/25/2014
8-81 Application to Use Radioactive Materials - sublicense EH&S - Radiation 05/10/2008
8-82 Request for Radiation Dosimeter Form EH&S - Radiation 05/10/2008
8-83 Request to Purchase Radioactive Materials Form EH&S - Radiation 05/10/2008
8-84A Radiation Safety Evaluation - Radioactive Materials EH&S - Radiation 05/10/2008
8-84B Radiation Safety Evaluation - Radiation-Producing Machines EH&S - Radiation 04/03/2014
8-84C Laser Safety Evaluation (Class 3b & 4 Lasers) EH&S - Radiation 08/04/2011
8-85 Pregnancy Declaration EH&S - Radiation 04/10/2008
8-86 Pregnancy Declaration Withdrawal EH&S - Radiation 04/10/2008
8-87 Biosafety Level 2 (BSL-2) Commissioning Checklist EH&S - Biological 01/06/2015
8-88 Laser Registration Form EH&S - Radiation 01/05/2012
8-89 Radiation Producing Machine Registration (RPMR) EH&S - Radiation 01/21/2015
8-90 Consent for Minor in a Laboratory - Covered Activities EH&S 11/18/2014
8-91 Authorization for Minors in Laboratories - Covered Activities EH&S 11/18/2014
8-92 Laboratory Tour for Minors Notification Form EH&S 11/18/2014
8-93 Consent for Minor in a Laboratory - Tours EH&S 12/09/2014
8-94 Minors in Laboratories - Restriction Exception Request EH&S 11/18/2014
8-100 Justification to Retain Expired Chemicals EH&S - CEMS 05/20/2014
8-102 CEMS Inventory Discrepancy EH&S - CEMS 05/20/2014
8-103 Chemical Donation Approval Request EH&S - CEMS 09/03/2014
8-104 Biological Indicator Test Results Log EH&S - Biological 12/19/2014
9-1A Report of Medical History and Health Evaluation Health Services 09/20/2011
9-2 Financial Policy Health Services 08/03/2012
9-3 Authorization to Treat Minors Health Services 04/12/2012
9-4 Consent for Treatment of a Minor Who Does Not Have Legal Power to Consent Health Services 09/14/2011
9-5 Notice of Privacy Practices Health Services 03/20/2012
9-7 Authorization for the Use and Disclosure of Protected Health Information Health Services 09/14/2011
9-8 Authorization for the Use and Disclosure of Protected Health Information to Outside Entity Health Services 09/14/2011
12-1 Guest Apartment Reservation Request Guest Apartments 04/30/2014
13-1 Faculty or Staff Organization Registration Business Affairs and Controller 07/24/2012
13-4 Procedure Template Administrative Information Management 07/24/2012
13-5 Forms and Exhibits Template Administrative Information Management 07/24/2012
13-6 Records Disposition Log Records and Information Management 07/24/2012
13-7 Request for Authority to Dispose of Unscheduled University Records Records and Information Management 07/24/2012
13-8 Records Retention Schedule Departmental Records Amendment Records and Information Management 07/24/2012
13-9 Preliminary Summary Report of Tort Claims and Possible Tort Claims Business Affairs and Controller 07/24/2012
13-10 Records Retention Recertification and Survey Records and Information Management 07/24/2012
14-1 Photographic Consent and Release Form General 08/24/2011
15-10 Alcoholic Beverage Request Form Dining Services 02/12/2015
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations 08/06/2010
15-15 Release and Indemnification Agreement for Adult Students Administration and Campus Operations 08/06/2010
15-16 Release and Indemnification Agreement for Adults Administration and Campus Operations 08/06/2010
15-17 Food Waiver Request Application Dining Services 03/26/2015
18-1 Computing Device Encryption Exception Request Information Security Office 07/23/2014
18-2 Information Resource Vulnerability Risk Acceptance Form Information Security Office 03/09/2015
18-4 Server Management Policy (HOP ADM 5-602) Exception Form Information Security Office 10/17/2014
19-1 Server Hosting Service Level Agreement Office of Information Technology 09/13/2011
19-2 Emergency Computer Request Form Office of Information Management 10/09/2014
20-1 Gift Record Form Office of Development 12/10/2014
20-2 UT Arlington Payroll Deduction Gift Form Payroll/Development 05/05/2014
20-3 Craig H. Neilsen Foundation Scholarship for Students with Spinal Cord Injury Development 12/17/2014
20-4 Deed of Gift Office of Development 05/13/2015
21-1 Request for Disbursement of Scholarship/Fellowship Award Scholarships 01/12/2011
21-2 Scholarship Committee Chair Scholarships 06/09/2010
22-1 Complaint Form Equal Opportunity Services 04/01/2009
22-2 Request to Initiate H-1B Equal Opportunity Services 12/01/2014
22-3 H-1 Foreign Employee Questionnaire Equal Opportunity Services 12/01/2014
22-4 Departmental Request to Initiate Legal Permanent Resident Equal Opportunity Services 06/08/2012
23-1 Life Safety Addendum Housing - Residence Hall 04/08/2009
23-4 Roommate Agreement Housing - Residence Hall 04/08/2009
23-5 Transfer Application Packet Housing - Apartments 04/08/2009
23-7 Carpet Evaluation Request Housing - Apartments 04/08/2009
23-8 Cleaning and Sanitation Inspection Housing - Apartments 04/08/2009
23-9 Lease Assumption Application Packet Housing - Apartments 04/08/2009
23-11 Occupant Termination Notice Housing - Apartments 05/16/2013
24-1 Handbook of Operating Procedures Policy Template Format Guidelines President's Office 01/05/2011
25-1 Consent to Obtain Medical Treatment for Minor Child General 04/06/2012
26-1 Campus Program Employee Listing Compliance Services 03/26/2015
27-1 Campus Event Planning Sheet (CEPS) Student Activities & Organizations 01/14/2015
27-2 Posting Form Student Activities & Organizations 09/24/2014
27-3 Student/Group Travel Form Student Activities and Organizations 09/19/2014
27-4 Student Organization Alcohol Addendum Division of Student Affairs 12/15/2014
28-1 Public Information Request The Office of University Counsel 05/06/2015