Forms
Compensation
- Job Description Form
- Compensatory Time Off Agreement
- Interim Agreement Form
- Secondary Assignment Request Form
Disability
Employment
- Background Check Request Form
- Dual Career Consultation Form
- Hiring of Minors Request Form
- Performance Review Forms
- WVUHire Permissions Request Form
General
- Authorization for Release of Benefits Information
- Employee Injury Incident Report Form
- Flexible Work Arrangement Form
- Mailing List Request
- Request for Years of Service Verification Form
- Other State Agency Request Verification Form
- Telecommuting Agreement
Health Insurance
- PEIA Forms
- Includes forms such as:
- Change-in-Status
- Change of Address
- Beneficiary Update
- Dependent Out of Area Form
- PEIA Shopper's Guides
- PEIA Plan Documents
Time Off (Leave)
- Annual Leave Extension Request Form
-
Catastrophic Leave Donor Application
- Catastrophic Leave Recipient Application
- Medical Verification Form
- Medical Verification Form, Immediate Family
- Parental Leave From
- Request for Personal Leave of Absence
- Request for Leave Adjustment
Retirement
- FBMC Retiree Enrollment form
- Phased Retirement Agreement
- PEIA Retiree Health Benefits and Basic Life Insurance Enrollment Form
- PEIA Retiree Optional/Dependent Life Insurance Enrollment Form
- Retiree Accrued Leave-Years of Service Conversion For
- Retiree Medicare Information Letter
-
SRA Salary Reduction Agreement
- State Teacher's Retirement System (STRS) Enrollment Form
-
TIAA 403(b) Enrollment
- TIAA 457(b) Enrollment
- TIAA Beneficiary Change
- TIAA Change in Address Form
- TIAA Name Change
- AIG Beneficiary Change Form
- AIG Cancellation Form
- AIG Enrollment Form
- Mountaineer Flex Benefits Enrollment/Change in Status Form
- PEIA Optional/Dependent Life Insurance Enrollment Form
- PEIA Basic and Optional Life Change of Beneficiary Form
- Mt. Flex Benefits Enrollment Form
- TIAA (HealthEquity) Health Savings Account Enrollment/Change Form