Forms and Documents

• Changes or Corrections of Personal Data (UH Form 33)
• ERS Mailing Address Change Form
• EUTF Employee Address Change Form

• Designation of Beneficiary (SOH D-90) must be printed on canary yellow paper
• Employee Retirement System (contributory and hybrid members only)
• Life Insurance (link to USAble Life)

Affordable Care Act Acknowledgement Form

Employee Union Trust Fund (EUTF)

• Forms (link to EUTF)

Flex Spending

• Enrollment Form
• Claim Form
• Direct Deposit Form

Retirement

• Claim for Service
• Online Information Correction Form
• Supplemental Retirement Savings

Temporary Disability

Transportation

Pre-Tax Transportation Benefit Pilot Program (Bus Pass)

• Participant Guide
• Processing Schedule 2015-2016
• Procedure and Forms

Tuition Waiver

• Employee Tuition Wavier Form
• Declaration of Marital Status or Domestic Partnership

Workers’ Compensation

• UH Rental Application

• Link to Leave Information

What You May Need To Know As You Leave UH Employment (rev 07/17)

• Checklist
  • BOR employee (PDF)
  • BOR employee (MS Word)
  • Civil Service: Hourly PRIOR to Start Date (A)
  • Civil Service: Hourly AFTER Start Date (B)
  • Civil Service: Salary PRIOR to Start Date (C)
  • Civil Service: Salary AFTER Start Date (D)
  • Transferring to UH
• Act 179 Acknowledgement Form (UH Form 109)
• Designation of Beneficiary (Form D-90)
• Direct Deposit (UH Form D-60)
• Disclosure of the Employment of Relatives (UH Form 88)
• Emergency Contact Information
• Employee Self-Identification (Ethnic Background)
• Faculty Level Pay Option Agreement
• General Confidentiality Notice (UH Form 92)
• I-9 Employment Eligibility Verification Form (rev 07/17/17)
• Invention Disclosure & Assignment Agreement (select appropriate form; Faculty form should be printed on department letterhead)
• Invitation to Self-Identify Veteran and/or Disability Status
• Notices to Employees
  • Benefits & Other Related Information Summary
  • Drug-Free Workplace Policies
  • Employee Assistance Program Flyer
  • EEO/AA Directors and Campus Coordinators
  • State Ethics Guidelines
  • Family and Medical Leave Act (FMLA) Poster
  • Federal Tax Limit on Pension Compensation
  • Importation and/or Shipment of Laboratory Materials
  • Sex Discrimination and Gender-Based Violence (Interim Policy)
  • Nondiscrimination and Affirmative Action E1.202
  • Tobacco Products Policy (E10.102)
  • VP Smith’s Memo for Temporary Hires
  • Workplace Non-Violence (EP 9.210)
• Emergency Contact Information
• PTS Deferred Compensation Retirement Plan
  • Booklet
  • Enrollment Form
  • Welcome Letter
• Recruitment
  • Candidate Release Form
  • DNHR Report (for MHR purposes)
  • Online Application Data System Manual
  • Form 17A (for civil service)
  • Form 17g (for GAs)
• Vacation or Off-Duty Plan Election Form (faculty who accrue vacation only)
• Verification of ERS Membership Info

• APT Overtime vs Overload
• Casual and Overload Form (UH Form 6)
• D-55 Timesheet – Hourly, Overtime, Differential Pay
• D-55 Timesheet Instructions
• Request for Overtime Work (UH Form 10)
• Request for Overload (UH Form 3)

• Hazard Assessment Certification
• Purchase Authorization Form
• Purchase Authorization Instructions
• Purchasing Instructions

• Exit Checklist
• Employee’s Retirement System – Leaving Employment brochures
• ITS – What happens to my UH email account when I leave the UH system?
• Vacation Pay Deferral Program
  • This is a program that provides State employees the ability to defer, to the employee’s deferred compensation plan, pay or compensation that he or she receives for unused vacation leave credits due to separation from service (i.e. resignation, retirement, termination, etc.).
  • Deferring pay for unused vacation leave credits (usually a sizeable amount) can provide tax-savings on such pay in addition to significantly increasing an employee’s retirement savings.
• What You May Need to Know as You Leave University of Hawai‘i Employment

• Claim for Prior Creditable Service for Awards (UH Form 12)

• HW-4 (State)
• W-4 (Federal)

• ID Application for Faculty/Staff
• Lecturer Work Schedule Disclosure Form
• Record of Outside Employment (UH Form 50)