Forms/Exhibits Disposition Table

  • This Disposition Table is a history of UT Arlington Business Affairs, Human Resources, and Campus Operations forms and exhibits.
  • The date is an estimate of when the events shown in the Status column occurred.
  • Some form numbers were reused by re-issuing the number of a discontinued form to new one created.

By default, columns are sorted by form number. You may change the sort by clicking on the table headings.

For questions or corrections, contact UT Arlington Administrative Information Management at aim@uta.edu.

Index Title Owner Status Date
1-1 Departmental Payroll Voucher Payroll Services Published 01/01/1999
1-1 Budget Request for Fiscal Year Payroll Services Discontinued 11/01/1993
1-2 Check Distribution & Change of Address Payroll/Accounting Published 01/01/1999
1-2 Fiscal Year 1993 Budget Planning Justifications Forms Payroll/Accounting Discontinued 11/01/1993
1-3 Earnings Statement Payroll Services Discontinued 09/24/2008
1-3A Annual Budget Request for Student Service Fee Allocations Payroll Services Discontinued 11/01/1993
1-3 Annual Income Budget Projections Payroll Services Discontinued 11/01/1993
1-4 W-5 Earned Income Credit Advance Pay Certificate Payroll/IRS Discontinued 01/01/2009
1-4 W-5 Earned Income Credit Advance Pay Certificate Payroll Services Discontinued 03/23/2006
1-4 1998 Form W-5 Payroll/IRS Discontinued 01/01/1999
1-4 Monthly Budget Listing Payroll/IRS Discontinued 11/01/1993
1-5C Weekly Employee Time Record Payroll Services Published 05/02/2014
1-5D Weekly Exempt Time Record Payroll Services Published 05/02/2014
1-5A Monthly Employee Time Record Payroll Services Published 08/31/2012
1-5B Hourly Employee Time Record Payroll Services Published 04/26/2012
1-5 UTA Time Card Payroll Services Discontinued 01/01/1999
1-5 Request for Budget Change Payroll Services Discontinued 11/01/1993
1-6 Departmental Vacation/Holiday Payroll Voucher Payroll Services Published 01/01/1999
1-6.1 Blanket Request Reappointments Payroll Services Discontinued 11/01/1993
1-6 Summer Session Budget Planning Document Payroll Services Discontinued 11/01/1993
1-7 Salary Spread Request Payroll Services Published 01/01/1999
1-8B Authorization for Professional Services (Less than $600) Payroll Services Published 03/07/2011
1-8C Statement for Foreign National Honoraria Recipients Payroll Services Published 02/23/2011
1-8 Authorization for Professional Services with Instructions Payroll/Accounting Discontinued 02/22/2011
1-8A Authorization for Professional Services Payroll/Accounting Published 11/10/2008
1-8 Authorization for Professional Services Payroll/Accounting Published 01/01/1999
1-9 Payee Information Form Payroll/Accounting Published 01/01/1999
1-10 Visa Waiver Countries Payroll Services Discontinued 09/24/2008
1-11 W-7 Application for IRS Individual Taxpayer Identification Number Payroll Services Discontinued 09/30/2008
1-12 Countries with Tax Treaties Payroll Services Discontinued 09/24/2008
1-13 IRS 8233 Form Payroll Services Discontinued 09/24/2008
1-14 Payment Request Form - Nonresident Alien Employees/Students Payroll Services Discontinued 09/24/2008
1-17 GLACIER Password - Nonresident Alien Tax Software Payroll Services Published 09/06/2007
1-18 Request for Taxpayer Identification Number and Certificaiton Payroll Services Published 06/07/2005
1-19 W-4 Employee's Withholding Allowance Certificate Payroll/IRS Published 03/23/2006
1-19 W-4 Employees Withholding Allowance Certificate Payroll/IRS Published 11/30/1999
1-20 W-9 Request for Taxpayer Identification Number and Certification Payroll Services Discontinued 09/30/2008
1-21 SS-5 Application for Social Security Card (Original/Replacement/Name Change) Payroll Services Discontinued 09/30/2008
1-22 TRS Web Site Password Authorization Payroll Services Discontinued 09/30/2008
1-23 Employee Change of Address Payroll Services/Human Resources Published 05/05/2014
2-1 Account Profile and Request for New Account Accounting Services Published 10/01/1991
2-2 Custodian and Working Fund Authorization Accounting Services Published 10/01/2004
2-2 Departmental Appropriation Ledger Accounting Services Discontinued 10/01/1991
2-3 Official Occasion Expense Form Accounting Services Discontinued 09/20/2007
2-3 Inter-Department Transfer Form Accounting Services Discontinued 11/15/1984
2-4 Check Distribution and Change of Address Accounting Services Discontinued 05/06/2008
2-4 Request for Student Organization University Account Accounting Services Discontinued 10/01/1991
2-5B Texas Sales and Use Tax Exemption Certification for Amazon.com Accounting Services Published 06/26/2012
2-5 Texas Sales and Use Tax Exemption Certification Accounting Services Published 11/16/2004
2-5 Gift Advice Accounting Services Discontinued 10/01/1991
2-6 Payment Approval Voucher Accounting Services Published 12/08/2004
2-6 Supplies Inventory Accounting Services Discontinued 10/01/1991
2-7 Departmental Deposit Accounting Services Published 12/08/2004
2-7 Summary - Inventory of Supplies and Materials for Resale Accounting Services Discontinued 10/01/1991
2-8 Restrictive Payee Stamp Accounting Services Published 12/08/2004
2-8 Request to Purchase - Grants Only Accounting Services Discontinued 10/01/1991
2-9 Restrictive Endorsement Stamp Accounting Services Published 12/08/2004
2-9 Payment Approval Voucher - Grants Only Accounting Services Discontinued 10/01/1991
2-10 Daily Check Log Accounting Services Published 12/08/2004
2-10 Departmental Transfer - Grants Only Accounting Services Discontinued 11/15/1984
2-11 Cash Receipt Accounting Services Published 12/08/2004
2-11 Personnel Activity Report Accounting Services Discontinued 10/01/1991
2-12 Statement of Accounts Reconciliation & Acknowledgement Accounting Services Published 12/08/2004
2-12 Payment Approval Voucher (Instructions and Form) Accounting Services Discontinued 08/31/1993
2-13 Direct Deposit Form for Students Accounting/Bursar Published 11/08/2005
2-13 Request for Governor's Approval for State Employees Traveling to Foreign Countries Accounting/Bursar Discontinued 08/31/1989
2-14 Custodian & Working Fund Authorization Discontinued 10/01/1991
2-15 Restrictive Payee Stamp Discontinued 11/01/1993
2-16 Restrictive Endorsement Stamp Discontinued 11/01/1993
2-17 Copy of a Check Discontinued 11/01/1993
2-18 Official Restrictive Endorsement Stamp Discontinued 11/01/1993
2-19 Texas Driver's License Discontinued 10/01/1991
2-20 Student and Faculty/Staff Identification Cards Discontinued 10/01/1991
2-21 Daily Check Log Discontinued 11/15/1984
2-22 Administrative Summons Discontinued 08/31/1986
2-23 Tuition Adjustment Form Discontinued 11/01/1993
2-24 Department Deposit Slip Discontinued 08/31/1990
2-25 Student Organization Payment Approval Voucher Discontinued 10/01/1991
2-26 Justification and Pro Forma Budget Student Financial Services Published 06/18/2007
2-27 Initial Recharge Rate Request Accounting Services Published 04/25/2013
2-30 Account Authorization Request Form & Instructions DEFINE Discontinued 05/14/2014
2-30 Account Authorization Request Form & Instructions DEFINE Published 03/07/2005
2-31 Dean-VP Routing Form & Instructions DEFINE Discontinued 05/14/2014
2-31 Dean-VP Routing Form & Instructions DEFINE Published 03/07/2005
2-32 *DEFINE User Setup & Instructions DEFINE Discontinued 05/14/2014
2-32 *DEFINE User Setup & Instructions (Individual) DEFINE Published 03/07/2005
2-33 Department Office Setup & Instructions (Entire Department) DEFINE Discontinued 03/19/2008
2-34 Electronic Signature Authorization Request DEFINE Discontinued 05/14/2014
2-34 Electronic Signature Authorization Request & Instructions DEFINE Published 03/07/2005
2-44 Certificate of Physical Inventory of Equipment Asset Management Discontinued 10/01/1991
2-45 Inventory Transaction Form Asset Management Published 10/01/1991
2-46 Equipment Purchase Notice Asset Management Discontinued 10/01/1991
2-47 Removal of Equipment from University Campus Asset Management Published 10/01/1991
2-48 Central Receiving Work Request Form Asset Management Published 12/10/2004
2-48 UTA Building Abbreviations Asset Management Discontinued 10/01/1991
2-49 Asset Information Form Asset Management Published 11/16/2004
2-49 Tips on Taking Annual Inventory Asset Management Discontinued 10/01/1991
2-50 Document Destruction Request Form Asset Management Published 06/15/2007
2-50 Inventory of Supplies and Materials for Resale Asset Management Discontinued 10/01/1991
2-51 Daily Report of Use of State-Owned Motor Vehicle Asset Management Discontinued 10/01/1991
2-60 Application for Nurse Faculty Exemption Student Financial Services Published 03/08/2006
2-61 Application for Preceptor Exemption Student Financial Services Published 03/08/2006
2-62 Nurse Faculty Loan Form Student Financial Services Published 12/22/2004
2-63 Perkins Loan Repayment Form Student Financial Services Published 12/22/2004
2-64 Post Census Tuition Adjustment Request Discontinued 05/06/2008
2-65 Application for Tuition Exemption per TEC 54.208 Peace Officer Enrolled in Criminal Justice Course/s Student Financial Services Published 08/04/2011
2-67 Waiver Appeal Student Financial Services Published 08/13/2014
2-90 Check Distribution & Change of Address Discontinued 05/06/2008
2-91 Request for Travel Authorization Travel Discontinued 05/05/2014
2-91 Request for Travel Authorization Travel Published 12/08/2004
2-92 Travel Voucher Travel Discontinued 05/05/2014
2-92 Travel Voucher Travel Published 12/08/2004
2-93 Travel Advance Voucher Travel Discontinued 05/05/2014
2-93 Travel Advance Voucher Travel Published 12/08/2004
2-94 Texas Sales and Use Tax Exemption Certification Travel Discontinued 11/06/2013
2-94 Texas Sales and Use Tax Exemption Certification Travel Published 07/06/2009
2-94 Texas Sales and Use Tax Exemption Certification Travel Published 12/08/2004
2-95 Texas Hotel Occupancy Tax Exemption Certificate Travel Published 12/08/2004
2-96 Metroplex Mileage Detailed Report Travel Published 12/08/2004
2-97 Travel Voucher Cover Sheet for Multiple Accts Travel Discontinued 05/05/2014
2-97 Travel Voucher Cover Sheet for Multiple Accts Travel Published 12/08/2004
2-98 Official Occasion Expense Form Travel Published 12/08/2004
2-99 Official Occasions-Entertainment Exp (Memo) Travel Discontinued 11/26/2011
2-100 Travel Voucher Cover Sheet Travel Published 12/08/2004
2-101 JPMorgan Chase Travel Cardholder Acct Travel Discontinued 10/03/2011
2-101 JPMorgan Chase Travel Cardholder Acct Travel Published 12/08/2004
2-103B Traveler Profile - Corporate Travel Planners Travel Discontinued 07/26/2013
2-103A Traveler Profile - Carlson Wagonlit Travel Discontinued 07/26/2013
2-103B Traveler Profile - Corporate Travel Planners Travel Published 07/20/2011
2-103 Traveler Profile Travel Discontinued 07/20/2011
2-103A Traveler Profile - Carlson Wagonlit Travel Published 07/20/2011
2-104 Non Employee Expense Reimbursement Travel Published 05/05/2014
2-245 Release of All Claims Discontinued 10/01/1991
3-1 Employee Requisition Form Human Resources Discontinued 11/01/1993
3-2 Position Audit Questionnaire Human Resources Discontinued 11/01/1993
3-3 Personnel Action Form Human Resources Published 03/30/2005
3-3 Personnel Transaction Form ( PO-1 ) Human Resources Discontinued 11/01/1993
3-4 Recruitment Summary for Classified Positions Human Resources Discontinued 11/01/1993
3-5 Record of FLSA (Overtime) Compensation Time Earned and Taken Human Resources Published 11/11/2004
3-5 Personnel Appointment Summary Form Human Resources Discontinued 11/01/1993
3-6 Immigration Reform and Control Act of 1986 Required Documents Human Resources Discontinued 11/01/1993
3-7 Form I-9, Employment Eligibility Verification Human Resources Published 02/02/2009
3-7 Employment Eligibility Verification ( Form I-9 ) Human Resources Published 12/06/2004
3-8 Notice of Voluntary Service Human Resources Published 03/30/2005
3-8 Personnel Termination Form ( PO-2 ) Human Resources Discontinued 11/01/1993
3-9 Criminal Background Check Human Resources Published 11/10/2004
3-9 Employer's First Report of Injury or Illness ( TWCC-1, 2-91 ) Human Resources Discontinued 11/01/1993
3-10 Supplemental Report of Injury ( TWCC-6, 7-93) Human Resources Discontinued 11/01/1993
3-11 Request for Paid Leave Due to On-The-Job Injury (WCI Form 23) Human Resources Discontinued 11/01/1993
3-11A Employer's Wage Statement ( TWCC Form 3 ) Human Resources Discontinued 11/01/1993
3-12 Performance Review Form Human Resources Discontinued 03/01/2009
3-12 Performance Review Form Human Resources Published 09/15/1987
3-13 Employee Separation Process Human Resources Discontinued 09/02/2010
3-13 Employee Separation Form Human Resources Published 08/31/1991
3-14 Employee Grievance Form Human Resources Discontinued 11/10/2010
3-14A Grievance Appeal Form Human Resources Discontinued 11/10/2010
3-14 Employee Grievance Human Resources Published 08/31/1990
3-14A Employee Grievance Appeal Human Resources Published 08/31/1990
3-15A Disciplinary Action Appeal - Continuation Human Resources Discontinued 11/22/2016
3-15 Appeal of Disciplinary Action - First Step Human Resources Discontinued 11/22/2016
3-15A Disciplinary Action Appeal - Continuation Human Resources Published 11/22/2016
3-15 Appeal of Disciplinary Action - First Step Human Resources Published 11/22/2016
3-15A Disciplinary Action Appeal - Continuation Human Resources Discontinued 11/21/2016
3-15 Appeal of Disciplinary Action - First Step Human Resources Discontinued 11/21/2016
3-15A Appeal of Disciplinary Action Continuation Human Resources Published 08/31/1990
3-15 Appeal of Disciplinary Action Human Resources Published 08/31/1990
3-16A Employee Clearance Form - Electronic Notification (PC Version) Human Resources Discontinued 03/10/2011
3-16B Employee Clearance Form - Electronic Notification (Mac Version) Human Resources Discontinued 03/10/2011
3-16B Employee Clearance Form - Electronic Notification (Mac Version) Human Resources Published 12/06/2004
3-16 Employee Clearance Form - Electronic Notification Human Resources Published 12/06/2004
3-16A Employee Clearance Form - Electronic Notification (PC Version) Human Resources Published 12/06/2004
3-16 Employee Check-Out Procedure Human Resources Discontinued 09/15/1987
3-17 Sick Leave Pool Contribution Human Resources Discontinued 11/01/1993
3-18A Statement of Attending Physician Human Resources Discontinued 11/01/1993
3-18 Sick Leave Pool Application Human Resources Published 08/31/1992
3-19 Outside Employment Human Resources Published 11/04/2009
3-19 Outside Employment Human Resources Published 03/30/2005
3-20 Driving Record Release Human Resources Discontinued 11/01/1993
3-21 Authorized Drivers Human Resources Discontinued 11/01/1993
3-22 Driver History Human Resources Discontinued 11/01/1993
3-23 Request for Family and Medical Leave Human Resources Published 07/07/2014
3-23 Affidavit of Dependency Tuition Adjustment Qualification Human Resources Discontinued 11/01/1993
3-23 Family Medical Leave Application Human Resources Published 11/01/1993
3-24 Return to Work Release Human Resources Published 02/27/2012
3-24 Certification of Physician or Practitioner Human Resources Discontinued 11/01/1993
3-25 Your Rights under the Family & Medical Leave Act of 1993 Human Resources Discontinued 11/01/1993
3-27B Instructions for Completing New Employment Paper Work Human Resources Discontinued 08/08/2016
3-27A New Employee Packet Human Resources Discontinued 08/08/2016
3-27A New Employee Paperwork Human Resources Published 07/17/2007
3-27B Instructions for Employee Packet Human Resources Published 07/17/2007
3-28 Employee Insurance Enrollment Application Human Resources Published 07/10/2007
3-29 Retiree Insurance Enrollment Application Human Resources Discontinued 08/13/2010
3-29 Retiree Insurance Enrollment Application Human Resources Published 07/10/2007
3-30 Benefits Cost Worksheet Human Resources Published 10/07/2010
3-30 Benefits Cost Worksheet Human Resources Published 07/10/2007
3-31 Dependent Enrollment and Status Change Form Human Resources Discontinued 08/13/2010
3-31 Dependent Enrollment and Status Change Form Human Resources Published 07/10/2007
3-32 UTFLEX Enrollment Form Human Resources Discontinued 08/13/2010
3-32 UTFLEX Enrollment Form Human Resources Published 07/10/2007
3-33 Coverage for Incapacitated Child Form Human Resources Published 07/10/2007
3-34 Medco Pharmacy Home Delivery Order Form (UT Select) Human Resources Published 07/10/2007
3-35 Medco Prescription Drug Claim Form (UT Select) Human Resources Published 07/10/2007
3-36 Transitional Benefits Form Human Resources Published 07/10/2007
3-37 UT Select Dental Claim Form Human Resources Published 07/10/2007
3-38 Superior Vision Provider Nomination Human Resources Published 07/10/2007
3-39 UT FLEX Claim Form Human Resources Published 07/10/2007
3-40 UT FLEX Direct Deposit Form Human Resources Published 07/10/2007
3-41 UT FLEX Letter of Medical Necessity Human Resources Published 07/10/2007
3-42 Fort Dearborn Term Life Beneficiary Designation Human Resources Published 07/10/2007
3-43 Optional Retirement Program (ORP) Retirement Certification Form Human Resources Discontinued 03/18/2008
3-44 Notice of Creditable Coverage for Medicare Part D Human Resources Published 07/10/2007
3-45 TRS Form 6 (Notice of Final Deposit and Request for Refund) Human Resources Published 07/10/2007
3-46 TRS Form 18 (Request for Estimate of Retirement Benefits) Human Resources Published 07/10/2007
3-47 Transfer Verification Form Human Resources Published 07/10/2007
3-48 TRS Form 28 (Notice to Elect to Participate in Optional Retirement Program) Human Resources Published 07/10/2007
3-49 TRS Form 29 (Application for Refund) Human Resources Discontinued 05/20/2014
3-49 TRS Form 29 (Application for Refund) Human Resources Published 07/10/2007
3-50 Authorization for Reduction for Employee Contributions Human Resources Published 07/10/2007
3-51 Authorization for Reduction for Employee Contributions for Employees returning to ORP Human Resources Published 07/10/2007
3-52 ORP Acknowledgement Form Human Resources Published 07/10/2007
3-53 Optional Retirement Program (ORP) Retirement Certification Form Human Resources Published 07/10/2007
3-54 Tax-Sheltered Annuity Disclosure Human Resources Published 07/10/2007
3-55 Purchase Change Agreement Human Resources Published 07/10/2007
3-56 Special Catch-Up Provision Disclosure Human Resources Published 07/10/2007
3-57 Short Term Disability Highlights Human Resources Published 01/07/2010
3-57 Short Term Disability Frequently Asked Questions Human Resources Published 07/10/2007
3-58 Long Term Care Brochure Human Resources Published 07/10/2007
3-59 COBRA Continuation Notice Human Resources Published 07/10/2007
3-60 HIPAA Privacy Information Human Resources Published 07/10/2007
3-61 Accidental Death and Dismemberment Benefits Guide Human Resources Published 07/10/2007
3-62 Assurant Dental HMO Benefits Guide Human Resources Published 07/10/2007
3-63 UT System Group Benefit Handbook for Employees Human Resources Published 10/07/2010
3-63 UT System Group Benefit Handbook for Employees Human Resources Published 07/10/2007
3-64 Group Term Life Benefits Guide Human Resources Published 07/10/2007
3-65 Employee Discount Program Participation Agreement Human Resources Discontinued 08/20/2009
3-65 Employee Discount Program Participation Agreement Human Resources Published 04/10/2008
3-66 Long Term Disability Benefits Guide Human Resources Published 07/10/2007
3-67 Short Term Disability Benefits Guide Human Resources Published 07/10/2007
3-67 Short Term Disability Benefits Guide Human Resources Published 07/10/2007
3-68 Superior Vision Benefits Guide Human Resources Published 07/10/2007
3-69 Teachers Retirement System (TRS) Handbook Human Resources Published 07/10/2007
3-71 UT Select Benefits Guide Human Resources Published 07/10/2007
3-72 UT Select Dental Benefits Guide Human Resources Published 07/10/2007
3-73 UT System Group Benefits Handbook for Retirees Human Resources Published 10/07/2010
3-73 UT System Group Benefits Handbook for Retirees Human Resources Published 07/10/2007
3-74 UT System Retirement Programs Guide Human Resources Published 07/10/2007
3-75 Exit Interview Questionnaire Human Resources Published 07/28/2010
3-76 Quest Release Time Form Human Resources Published 05/10/2008
3-77 Employee Tuition Certification Form Human Resources Discontinued 08/28/2015
3-77 Employee Tuition Certification Form Human Resources Published 07/24/2008
3-78 Currently Under Revision. Please contact HR at 2-5554 for more details Human Resources Discontinued 02/09/2017
3-78 Classified Staff Evaluation Form - Narrative Format Human Resources Published 07/07/2014
3-79 Employee Self-Evaluation Form Human Resources Published 01/21/2011
3-80 Administrative and Professional Form Human Resources Published 04/05/2013
3-81 Classified Staff Evaluation Form - Check Box Format Human Resources Published 03/17/2014
3-82 Performance Management Forms Human Resources Published 02/18/2015
3-83 Currently Under Revision. Please contact HR at 2-5554 for more details Human Resources Discontinued 02/09/2017
3-83 Performance Management Form for New Employees Human Resources Published 05/03/2012
3-84 Sample Reference Check Form Human Resources Published 03/23/2009
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources Published 10/12/2011
3-85 On-Campus Summer Camp / Conference Employment Application Human Resources Discontinued 05/25/2011
3-87 Telecommuting Agreement Human Resources Published 02/12/2010
3-201 Personal Information Form Human Resources Published 07/16/2007
3-202 State Employment Verification Form Human Resources Published 03/04/2008
3-203 Selective Service Registration Verification Form Human Resources Published 03/04/2008
3-204 Sick Leave Pool Contribution Form Human Resources Published 11/11/2009
3-205 Financial Disclosure and Conflicts of Interest Human Resources Published 04/26/2010
3-206 Outstanding Maverick Award Nomination Form Human Resources Published 10/19/2011
3-207 Hiring Request Questions to Submit to Hiring Review Committee Human Resources Published 09/14/2012
3-208 Employee Tuition Reimbursement Program Request Form Human Resources Published 05/17/2016
3-210 Job Description HR Published 09/11/2017
4-1 Request to Purchase - Standard Request Procurement Discontinued 05/05/2014
4-1 Request to Purchase - Standard Request Procurement Published 08/31/1999
4-2 Request to Purchase (Sample) - Split Accounts Procurement Discontinued 05/05/2014
4-2 Request to Purchase - Split Accounts Procurement Published 08/31/1999
4-3 Request to Purchase (Sample) - Confirm Request Procurement Discontinued 05/05/2014
4-3 Request to Purchase - Confirmation Request Procurement Published 08/31/1999
4-4 Purchasing Card Reconciliation Log and Example Procurement Published 08/31/1999
4-5 Purchasing Card Transaction Log and Example Procurement Published 08/31/1999
4-6 Asset Information Form Procurement Discontinued 05/06/2008
4-7 Statement of Disputed Item Form ( ProCard) Procurement Discontinued 08/31/1999
4-8 Purchasing Card Application Procurement Published 08/31/1999
4-10 Vendor Performance Form Procurement Published 08/31/1999
4-11 Cardholder Agreement Procurement Published 08/31/1999
4-12 Major Consulting Services Contract Approval Request Procurement Discontinued 12/16/2011
4-12 Major Consulting Services Contract Approval Request Procurement Published 11/18/2004
4-12 Letter of Written Justification for a Single Source Procurement Procurement Discontinued 08/31/1999
4-13 Emergency Justification Procurement Discontinued 09/01/2015
4-13 Emergency Justification Procurement Published 11/30/2001
4-14C Request for Sole Source Purchase - Template for Software Maintenance Agreement with Original Licensor Procurement Discontinued 09/01/2015
4-14B Request for Sole Source Purchase - Template for Original Equipment Manufacturer (OEM) for Maintenance and Repair Procurement Discontinued 09/01/2015
4-14 Request for Sole Source Purchase (For Noncompetitive Purchases over $5000) Procurement Discontinued 09/01/2015
4-14C Request for Sole Source Purchase - Template for Software Maintenance Agreement with Original Licensor Procurement Published 05/05/2014
4-14B Request for Sole Source Purchase - Template for Original Equipment Manufacturer (OEM) for Maintenance and Repair Procurement Published 05/05/2014
4-14 Sole-Source/Proprietary Justification For Services Procurement Published 11/30/2001
4-15 Sole-Source/Proprietary Justification for Goods Procurement Discontinued 05/05/2014
4-15 Sole-Source/Proprietary Justification For Goods Procurement Published 11/30/2001
4-16 Gift Certificate Expense Form Procurement Published 06/14/2007
4-17 Comdata Corporation Dispute Processing Form Procurement Discontinued 12/17/2013
4-17 Comdata Corporation Dispute Processing Form Procurement Published 07/18/2007
4-18 Summus/Staples Application Procurement Discontinued 12/17/2013
4-18 Summus/Staples Application Procurement Published 06/18/2007
4-20 Vendor Direct Deposit / Advance Payment Notification Authorization Procurement Published 02/14/2011
4-21B Supplier Information Instructions Travel Published 05/05/2014
4-21 Supplier Information Travel Published 05/05/2014
4-22 University Issued Cell Phone Request Form Procurement Published 07/06/2015
4-23 Cell Phone Acceptance Form Procurement Published 07/06/2015
4-24 Exclusive Acquisition Justification Form Procurement Published 09/01/2015
4-25 Best Value Determination form Procurement Discontinued 12/23/2015
4-25 Best Value Determination form Procurement Published 12/23/2015
4-26 Request For Proposal (RFP) / Request For Qualifications (RFQ) Initiation Procurement Services Published 08/08/2016
5-1 Notice to Department - Automotive Preventative Maintenance Schedule Facilities Discontinued 08/31/1999
5-2 2nd Notice to Department - Automotive Preventative Maintenance Schedule Facilities Discontinued 08/31/1999
5-3 Sample Interdepartmental Transfer for Vehicle Repair Facilities Discontinued 08/31/1999
5-4 Vehicle Request Form Facilities Published 12/08/2004
5-5 Operation of UTA 15-Passenger Vans Facilities Published 12/08/2004
5-20 Proposal Request Form Office of Development and Alumni Relations Published 04/11/2017
6-1 GTA Parking Permit Decal Permission Police Published 07/25/2006
6-1 Key Return/Receipt Police Discontinued 08/31/1999
6-2 Special Parking Permit/Salary Verification Police Discontinued 06/15/2007
6-2 Key Control Department/Payment for Lost Keys Police Discontinued 08/31/1999
6-3 Key Request Police Published 08/30/2011
6-3 Key Request Issuance and Receipt Police Discontinued 08/31/1999
6-4 Lost or Missing University Inventory Report Form Police Published 08/24/2011
6-5 Lost Property Report Form Police Published 02/25/2011
7-1 Request to Host a Camp/Conference Conference Services Published 05/03/2011
7-2 Facility Insurance Agreement Conference Services Discontinued 09/12/2012
7-2 Facility Insurance Agreement Conference Services Published 05/03/2011
7-3 Summer Conference Housing Reservation Request Conference Services Published 05/03/2011
7-4 Summer Conference Dining Request Conference Services Published 05/03/2011
7-5 Admissions Tours and Presentation Request Conference Services Discontinued 10/14/2013
7-5 Admissions Tours and Presentation Request Conference Services Published 05/03/2011
7-6 Conference Services IDT Form Conference Services Published 07/12/2011
7-7 Consent to Obtain Medical Treatment for Minor Child Conference Services Published 07/12/2011
7-9 Department Event Request E.H. Hereford University Center Published 08/19/2011
7-10 Summer Camp Online Training Request Conference Services Discontinued 10/18/2012
7-10 Summer Camp Online Training Request Conference Services Published 05/08/2012
7-11 Event Change/Cancellation University Center Published 08/30/2012
7-12 External Reservation Form University Center Published 08/30/2012
8-1 Instructions for Employers First Report of Injury or Illness EH&S - WCI Discontinued 06/01/2000
8-2 Supervisor's Report of Employee Work-Related Injury or Occupational Disease EH&S - WCI Published 10/24/2007
8-2 Employers First Report of Injury or Illness EH&S - WCI Discontinued 06/01/2000
8-3 Supplemental Report of Injury EH&S - WCI Discontinued 06/21/2013
8-3 Supplemental Report of Injury EH&S - WCI Published 06/24/2008
8-3 Supplemental Report of Injury EH&S - WCI Discontinued 02/28/2008
8-3 Instructions for TWCC-6 (Supplemental Report of Injury) EH&S - WCI Discontinued 06/01/2000
8-3A Supplemental Report of Injury EH&S - WCI Discontinued 06/01/2000
8-4 Request for Paid Leave Due to On-The-Job Injury EH&S - WCI Discontinued 06/21/2013
8-4 Request for Paid Leave Due to On-The-Job Injury EH&S - WCI Published 06/01/2000
8-5 Employer's Wage Statement EH&S - WCI Discontinued 02/28/2008
8-6 Employee's Report of Work-Related Injury or Occupational Disease EH&S - WCI Published 06/01/2000
8-7 Detailed Description of Injury/Illness and Accident Scene EH&S - WCI Discontinued 11/02/2007
8-8 Modified Work Duty Agreement EH&S - WCI Discontinued 06/01/2000
8-9 Notification of Work-Related Injury EH&S - WCI Published 12/08/2004
8-9 Return to Work Certification EH&S - WCI Discontinued 06/01/2000
8-10C Injured Employee Workers Compensation Guidelines (Vietnamese) EH&S - WCI Published 06/13/2013
8-10B Injured Employee Workers Compensation Guidelines (Spanish) EH&S - WCI Published 06/13/2013
8-10A Injured Employee Workers Compensation Guidelines (English) EH&S - WCI Published 06/13/2013
8-10 Injured Employee Workers Compensation Guidelines EH&S - WCI Published 04/14/2005
8-11 Supervisor's Workers Compensation Checklist EH&S - WCI Published 04/14/2005
8-12 Workers Compensation Injury/Incident Witness Statement EH&S - WCI Discontinued 06/21/2013
8-12 Workers Compensation Injury Witness Statement EH&S - WCI Published 02/21/2005
8-13 Ergonomic Evaluation Request EH&S - Occupational Published 08/10/2006
8-14 Workers’ Compensation Pharmacy Information EH&S - WCI Published 07/29/2013
8-14 myMatrixx First Fill Pharmacy Card EH&S - WCI Discontinued 07/18/2013
8-14 myMatrixx First Fill Pharmacy Card EH&S - WCI Published 01/29/2010
8-14 HSI Rx First Fill Pharmacy Card EH&S - WCI Discontinued 09/01/2009
8-14 Bridgeway First Fill Pharmacy Card EH&S - WCI Published 01/30/2008
8-15 Work Status Report and Instructions EH&S - WCI Discontinued 06/21/2013
8-15 Work Status Report and Instructions EH&S - WCI Published 02/01/2011
8-15 Work Status Report and Instructions EH&S - WCI Published 02/28/2008
8-16 Workers Compensation Insurance Employee Request for Reimbursement of Medical Expenses EH&S - WCI Discontinued 06/21/2013
8-16 Workers Compensation Insurance Employee Request for Reimbursement of Medical Expenses EH&S - WCI Published 06/24/2008
8-17 Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease EH&S - WCI Discontinued 06/21/2013
8-17 Employee's Claim for Compensation for a Work-Related Injury or Occupational Disease EH&S - WCI Published 06/24/2008
8-18 Notice of Fatal Injury or Occupational Disease and Claim for Compensation for Death Benefits EH&S - WCI Discontinued 06/21/2013
8-18 Notice of Fatal Injury or Occupational Disease and Claim for Compensation for Death Benefits EH&S - WCI Published 06/24/2008
8-19 Employee's Request to Change Treating Doctor - Non Network EH&S - WCI Discontinued 06/21/2013
8-19 Employee's Request to Change Treating Doctor - Non Network EH&S - WCI Published 06/24/2008
8-20A Workers' Compensation Network Acknowledgement (English) EH&S - WCI Published 11/07/2014
8-20C Workers' Compensation Network Acknowledgement (Vietnamese) EH&S - WCI Published 04/01/2013
8-20B Workers' Compensation Network Acknowledgement (Spanish) EH&S - WCI Published 04/01/2013
8-21C Notice of Network Requirements for UT System (Vietnamese) EH&S - WCI Published 04/01/2013
8-21B Notice of Network Requirements for UT System (Spanish) EH&S - WCI Published 04/01/2013
8-21A Notice of Network Requirements for UT System (English) EH&S - WCI Published 04/01/2013
8-26 Laboratory Safety Evaluation (Biological) EH&S - Biological Discontinued 09/29/2016
8-26 Biosafety Lab Evaluation Form EH&S - Biological Published 08/01/2005
8-27 Survey of Biological Agents Form EH&S - Biological Discontinued 11/06/2009
8-27 Survey of Biological Agents Form EH&S - Biological Published 08/01/2005
8-28 Request for Disposal Form - Biological Waste and Sharps EH&S - Biological Discontinued 07/19/2012
8-28 Request for Disposal Form - Biological Waste and Sharps EH&S - Biological Published 08/01/2005
8-29 Hepatitis B Vaccine Waiver EH&S - Biological Published 05/21/2008
8-30 Human Pathogen Registration Document EH&S - Biological Published 05/21/2008
8-31 Human Pathogen Registration Update EH&S - Biological Published 05/21/2008
8-32 Verification of Training on Vaccinia Virus, Recombinant Vaccinia Viruses, or Other Orthopoxviruses that Can Infect Humans EH&S - Biological Published 12/06/2012
8-33 Autoclave Waste Treatment Log EH&S - Biological Published 11/02/2011
8-34 Hepatitis B Vaccination/Hepatitis B Vaccine Waiver/Exemption EH&S - Biological Published 09/16/2014
8-36 Laboratory Safety Evaluation EH&S - Chemical Discontinued 09/29/2016
8-36 Laboratory Safety Evaluation Checklist EH&S - Chemical Published 09/09/2005
8-37 Request for Disposal - Hazardous Chemicals EH&S - Chemical Discontinued 12/06/2011
8-37 Request for Disposal - Hazardous Chemicals EH&S - Chemical Published 09/09/2005
8-46 Hazard Reporting Form EH&S - DSL Discontinued 01/24/2017
8-46 UTA Hazard Reporting Form EH&S - DSL Published 10/05/2005
8-55 Request for Review of Motor Vehicle Record (MVR) Environmental Health & Safety Published 05/03/2017
8-56 Application for Copy of Driver Record EH&S - Driving Discontinued 09/13/2017
8-56 Application for Copy of Driver Record EH&S - Driving Published 03/13/2017
8-56 Application for Copy of Driver Record EH&S - Driving Discontinued 02/27/2017
8-56 Application for Copy of Driver Record EH&S - Driving Published 08/10/2005
8-61 Hot Work Permit EH&S - Fire Discontinued 07/19/2012
8-61 UTA Hot Work Permit EH&S - Fire Published 09/08/2005
8-62 Charcoal and Propane Grill Permit EH&S - Fire Published 07/17/2012
8-63 Tent Permit Request Form EH&S - Fire Published 08/15/2012
8-64 Exchange of Lockout/Tagout Program EH&S - Occupational Published 02/16/2015
8-65 Energy Control Procedures EH&S - Occupational Published 02/16/2015
8-66 Lockout/Tagout Authorized Employee Training Form EH&S - Occupational Published 03/13/2006
8-67 Lockout/Tagout Request Form EH&S - Occupational Discontinued 02/11/2015
8-67 Lockout/Tagout Request Form EH&S - Occupational Published 03/13/2006
8-68 Lockout/Tagout Master Index Form EH&S - Occupational Discontinued 02/11/2015
8-68 Lockout/Tagout Master Index Form EH&S - Occupational Published 03/13/2006
8-69 Lockout/Tagout Periodic Inspection Form EH&S - Occupational Discontinued 02/11/2015
8-69 Lockout/Tagout Periodic Inspection Form EH&S - Occupational Published 03/13/2006
8-70 First Aid Kit Supply Request Form EH&S - Occupational Published 03/13/2006
8-71 IAQ Occupant Interview Form EH&S - Occupational Published 03/13/2006
8-72 Student Visitor Injury-Illness Form EH&S - Occupational Published 10/18/2007
8-73 Confined Spaces Entry Plan EH&S - Occupational Published 08/29/2011
8-74 Confined Spaces Inventory Form EH&S - Occupational Published 08/29/2011
8-75 Shop Safety Evaluation Checklist EH&S - Occupational Discontinued 09/29/2016
8-75 Shop Safety Evaluation Checklist EH&S - Occupational Published 05/22/2014
8-77 Roof Access Request EH&S - Occupational Published 07/25/2014
8-81 Application to Use Radioactive Materials EH&S - Radiation Published 08/17/2005
8-82 Request for Radiation Dosimeter Form EH&S - Radiation Published 08/17/2005
8-83 Request to Purchase Radioactive Materials Form EH&S - Radiation Published 08/18/2005
8-84C Radiation Safety Evaluation - Lasers EH&S - Radiation Published 08/18/2005
8-84A Radiation Safety Evaluation - Radioactive Materials EH&S - Radiation Published 08/18/2005
8-84B Radiation Safety Evaluation - X-Ray Producing Machines EH&S - Radiation Published 08/18/2005
8-85 Pregnancy Declaration EH&S - Radiation Published 02/15/2008
8-86 Pregnancy Declaration Withdrawal EH&S - Radiation Published 02/15/2008
8-87 Biosafety Level 2 (BSL-2) Commissioning Checklist EH&S - Biological Published 02/09/2009
8-88 Laser Registration Form EH&S - Radiation Published 03/10/2009
8-89 Radiation Producing Machine Registration (RPMR) EH&S - Radiation Published 04/05/2012
8-90 Consent for Minor in a University of Texas at Arlington Laboratory EH&S Published 08/15/2012
8-91 Authorization for Minors in Laboratories EH&S Published 08/15/2012
8-92 Laboratory Tour for Minors Notification Form EH&S Published 11/18/2014
8-93 Consent for Minor in a Laboratory - Tours EH&S Published 12/03/2014
8-94 Minors in Laboratories - Restriction Exception Request EH&S Published 11/18/2014
8-100 Justification to Retain Expired Chemicals EH&S - CEMS Discontinued 06/04/2015
8-100 Justification to Retain Expired Chemicals EH&S - CEMS Published 05/20/2014
8-101 CEMS Alternative Inventory Schedule Request EH&S - CEMS Discontinued 10/15/2014
8-101 CEMS Alternative Inventory Schedule Request EH&S - CEMS Published 05/20/2014
8-102 CEMS Inventory Discrepancy EH&S - CEMS Published 05/20/2014
8-103 Chemical Donation Approval Request EH&S - CEMS Published 09/03/2014
8-104 Biological Indicator Test Results Log EH&S - Biological Published 12/19/2014
8-105 Fire Pit Permit Environmental Health and Safety Published 03/17/2016
8-106 Request for Chemical-Free Area Designation Environmental Health & Safety Published 08/09/2016
9-1A Report of Medical History and Health Evaluation Health Services Published 09/20/2011
9-1 Description of a Large System Development Project Office of Information Technology Discontinued 08/31/1990
9-2 Financial Policy Health Services Published 06/28/2011
9-2 Request for Administrative Information Systems Services Office of Information Technology Discontinued 08/31/1990
9-3 Computer Configuration in Administrative Information Systems Office of Information Technology Discontinued 08/31/1990
9-4 Consent for Treatment of a Minor Who Does Not Have Legal Power to Consent Health Services Published 09/14/2011
9-5 Notice of Privacy Practices Health Services Published 01/06/2012
9-5 Notice of Privacy Practices (Short Version) Health Services Discontinued 09/14/2011
9-6 Notice of Privacy Practices (Long Version) Health Services Discontinued 09/14/2011
9-6 Notice of Privacy Practices (Long Version) Health Services Published 06/08/2010
9-7 Authorization for the Use and Disclosure of Protected Health Information Health Services Published 06/06/2011
9-8 Authorization for the Use and Disclosure of Protected Health Information to Outside Entity Health Services Published 09/14/2011
9-8 Request and Authorization for Release of Student Medical Information Health Services Discontinued 06/30/2011
9-8 Authorization for the Use and Disclosure of Protected Health Information to Outside Entity Health Services Published 06/06/2011
11-1 Paper Order Request Maverick Print Discontinued 06/24/2011
11-1 Paper Order Form Maverick Print Published 12/08/2004
11-1 Printing Trade Customs Maverick Print Discontinued 08/31/1984
11-2 Forms Order Request Maverick Print Discontinued 06/24/2011
11-2 Forms Order Request Maverick Print Published 12/08/2004
11-2 Printing Order Form Maverick Print Discontinued 08/31/1984
11-3 Print Order Request Maverick Print Discontinued 06/24/2011
11-3 Print Order Form Maverick Print Published 12/08/2004
11-5 Print Proof Form Maverick Print Discontinued 05/06/2008
12-1 Guest Apartment Reservation Request Guest Apartments Published 09/01/2011
13-1 Faculty and Staff Organization Registration Form Administration and Campus Operations Published 12/08/2004
13-1 Affidavit for Faculty and Staff Organizations Administration and Campus Operations Discontinued 10/01/1991
13-2 Records Retention Log Business Affairs and Controller Discontinued 02/04/2009
13-2 Records Retention Log Business Affairs and Controller Published 12/08/2004
13-2 Faculty and Staff Organization Registration Form Business Affairs and Controller Discontinued 10/01/1991
13-4 Procedure Template Administrative Information Management Published 07/24/2012
13-4 Forms and Exhibits Template Business Affairs and Controller Discontinued 07/09/2010
13-4 Fiscal Procedure Exhibit Template Business Affairs and Controller Published 10/26/2007
13-5 Forms and Exhibits Template Business Affairs and Controller Published 07/09/2010
13-6 Records Disposition Log Records and Information Management Published 02/04/2009
13-7 Request for Authority to Dispose of Unscheduled University Records Records and Information Management Published 02/04/2009
13-8 Records Retention Schedule Departmental Records Amendment Records and Information Management Published 07/24/2012
13-9 Preliminary Summary Report of Tort Claims and Possible Tort Claims Business Affairs and Controller Published 08/25/2009
13-10 Records Retention Recertification and Survey Records and Information Management Published 03/08/2011
14-1 Photographic Consent and Release Form General Published 08/24/2011
15-1 Summer Conference Statement on Insurance Conferences Services Discontinued 05/03/2011
15-1 Summer Conference Statement on Insurance Conferences Services Published 03/27/2005
15-2 Summer Conference Admission Presentation Request Form Conferences Services Discontinued 05/03/2011
15-2 Summer Conference Admission Presentation Request Form Conferences Services Published 03/27/2005
15-3 Summer Conference Access Card & Hang Tag Form Conferences Services Discontinued 05/06/2008
15-4 Summer Conference Housing Reservation Form Conferences Services Discontinued 05/03/2011
15-4 Summer Conference Housing Reservation Form Conferences Services Published 03/27/2005
15-5 Summer Conference Dining Reservation Form Conferences Services Discontinued 05/03/2011
15-5 Summer Conference Dining Reservation Form Conferences Services Published 03/27/2005
15-6 Summer Conference E.H. Hereford University Center Facility Reservation Form Conferences Services Discontinued 07/12/2011
15-6 Summer Conference E.H. Hereford University Center Facility Reservation Form Conferences Services Published 03/27/2005
15-7 Summer Conference Activities Building Rental Application Conferences Services Discontinued 05/03/2011
15-7 Summer Conference Activities Building Rental Application Conferences Services Published 03/27/2005
15-8 Summer Conference Texas Hall Reservation Request Conferences Services Discontinued 05/06/2008
15-9 Summer Conference Housing Equipment Issuance Authorization Conferences Services Discontinued 05/03/2011
15-9 Summer Conference Housing Equipment Issuance Authorization Conferences Services Published 05/27/2008
15-10 Alcoholic Beverage Request Form Dining Services Published 12/04/2008
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations Published 08/06/2010
15-13 Release and Indemnification Agreement for Minors Administration and Campus Operations Published 04/01/2010
15-14 Photographic Consent and Release Conferences Services Discontinued 05/03/2011
15-15 Release and Indemnification Agreement for Adult Students Administration and Campus Operations Published 08/06/2010
15-16 Release and Indemnification Agreement for Adults Administration and Campus Operations Published 08/06/2010
15-17 Food Waiver Request Application Dining Services Published 09/27/2012
15-18 Food Waiver Request Application, College Park Center Dining Services Published 12/03/2015
15-19 Event Application For Campus Departments and Organizations, College Park Center College Park Center Published 01/17/2017
15-20 Event Application For Outside Events College Park Center Published 01/17/2017
18-1 Portable Device Encryption Exception Request Information Security Office Published 08/09/2012
18-2 Information Resource Vulnerability Risk Acceptance Form Information Security Office Published 05/28/2014
18-4 Server Management Policy (HOP ADM 5-602) Exception Form Information Security Office Published 08/29/2014
19-1 Server Hosting Service Level Agreement Office of Information Technology Published 09/13/2011
19-2 Emergency Computer Request Form Office of Information Management Published 10/09/2014
20-1 UTA Gift Records Form Accounting/Development Published 12/08/2004
20-2 UTA Payroll Gift Deduction Form Payroll/Development Published 06/07/2005
20-3 Craig H. Neilsen Foundation Scholarship for Students with Spinal Cord Injury Procurement Services Published 05/19/2014
20-4 Deed of Gift Office of Development Published 05/13/2015
21-1 Request for Disbursement of Scholarship/Fellowship Award Scholarships Published 01/12/2011
21-1 Request for Disbursement of Scholarship/Fellowship Award Accounting/Financial Aid Published 12/16/2005
21-2 Scholarship Committee Chair Scholarships Published 06/09/2010
22-2 Request to Initiate H-1B Equal Opportunity Services Published 04/04/2013
22-4 Departmental Request to Initiate Legal Permanent Resident Equal Opportunity Services Published 07/23/2009
23-1 Life Safety Addendum Housing - Residence Hall Discontinued 02/03/2016
23-2 Move-in Checklist Housing - Residence Hall Discontinued 08/30/2012
23-3 Moving Checklist Housing - Residence Hall Discontinued 08/30/2012
23-4 Roommate Agreement Housing - Residence Hall Discontinued 02/03/2016
23-5 Transfer Application Packet Housing - Apartments Discontinued 02/03/2016
23-6 Apartment Move In Guide Housing - Apartments Discontinued 08/30/2012
23-7 Carpet Evaluation Request Housing - Apartments Discontinued 02/03/2016
23-8 Cleaning and Sanitation Inspection Housing - Apartments Discontinued 02/03/2016
23-9 Lease Assumption Application Packet Housing - Apartments Discontinued 02/03/2016
23-10 Move Out Guide Housing - Apartments Discontinued 08/30/2012
23-11 Occupant Termination Notice Housing - Apartments Discontinued 02/03/2016
25-1 Consent to Obtain Medical Treatment for Minor Child General Published 04/06/2012
25-1 Procedure Template Business Affairs Discontinued 07/09/2010
25-1 Procedure Template Business Affairs Published 06/16/2010
26-1 Campus Program Employee Listing Compliance Services Published 10/18/2012
27-1 Campus Event Planning Sheet (CEPS) Student Activities & Organizations Published 09/03/2014
27-2 Posting Form Student Activities & Organizations Published 09/24/2014
27-3 Student/Group Travel Form Student Activities and Organizations Published 09/19/2014
27-4 Student Organization Alcohol Addendum Division of Student Affairs Published 12/15/2014
28-1 Public Information Request The Office of University Counsel Published 05/06/2015
28-2 Contract Routing Office of University Compliance and Legal Affairs Published 09/11/2017