School Name

faculty and staff

Department Name

Main Content

Administrative Forms

UAPB Campus Map

Academic Affairs

Academic Early Warning Report 

Budget Office

Budget Amendment 

Motor Pool

Instructions for Vehicle Request Form
Vehicle Request Form

Human Resources

Benefit Forms
Medical Enrollment Form
Dental Enrollment Form
Vision Enrollment Form
Flexible Spending Account Enrollment Form
Flexible Spending Reimbursement Form
Group Benefits Enrollment Form
Group Benefits Change Form
Life Evidence of Insurability Form
Retirement -Salary Deferral Form
Retirement Acknowledgement Form
Retirement TIAA-CREF Beneficiary Change Form
Retirement Fidelity Investments Beneficiary Change Form
Pharmacy Appeal Form
Medical Appeal Form
Catastrophic Leave Form
Catastrophic Physician's Certification Form
Family Medical Leave Request Form
Family Medical Employee's Physician Certification Form
Family Medical Leave Employee Family Member's Certification Form
Worker's Compensation Incident Report (No Medical Required)

Recruitment Forms
Pre-Recruitment Form
New Classified Position Request
Unfreeze/Advertise Form
Background Check Release From
Notice of Vacancy

New Employee
Personnel Action-Regular Employee 
PAF - Extra-Help
Basic Data Form
W-4 (2016)
AR4EC-Arkansas State Withholding Form
J-1 Visa for Visiting Scholars

Payroll Forms
Direct Deposit Authorization Form
Direct Deposit (Secondary) Form
Payroll Authorization Form for WebAdvisor
Payroll Deduction Authorization

Timekeeping Forms

Time Record - Non-Exempt Employees
Time Record - Exempt Employees
Work-Study Time Record 
Extra-Help Overtime Record
Extra-Help Time Record
Overtime Approval Form
Overtime Record
Twelve Month Pay Authorization & Agreement
Leave Request Form

General Forms
Accommodations Process for Faculty and Staff with Disabilities
Annual Report of Extra Income Over $500 Form
Classified Performance Evaluation Form
Classified Employee Performance Evaluation Plan
Concurrent Employment Form (Internal)
Employee Accommodation Request Form 
Faculty/Staff Clearance Form
Notice of Termination
Grievance Form
Statement of Financial Interest (2015)

Central Receiving & Stores

Central Stores Requisition (revised)
Equipment Located Off-Campus
Moving Request Form
Stock Items (pdf)
Rental Agreement
Assembly Form

Controller's Office 

Agency Deposit and Withdrawal form
Deposit Transmittal Form
In-House Invoice
Reimbursement Claim Form
Walk-Through Request Form
Interdepartmental Chargeback

 Travel Authorization
 Non-State Travel
 Student Travel Authorization-Advance
 Student Group Meal Per Diem

Controller's Office Business Procedures
Facility Use Policy and Procedures
Fixed Asset Procedures
Investment Policy
Records Retention Schedule

Facilities Management

Lock & Key Request
Physical Plant Work Order (pdf)
Physical Plant Work Order (xls)
Capital Project Request

Printing Services

Businesscard, Letterhead Form
Design and Pre-Press
Duplication Form


Bidder's Application
Contract & Grant Disclosure Form
GUI Requisition
Official Function Form
Signature Authorization
Sole Source Justification

Student Involvement and Leadership

Space Request Form (please call 870.575.7061)