• Employee Information Form (PDF)
• Distribution Form  (PDF)  (For new employees only.)
• Personnel Action (PA) Change Form (PDF) - Change Form Instruction (PDF)
• Personnel Action (PA) Set-Up Form (PDF) - Set-Up Form Instructions (PDF)

• I-9 Printable Form (PDF)
• I-9 Fillable Form (PDF)
  • Only accessible via Internet Explorer
  • Must have the most recent version of Adobe 
• Checklist for I-9 Verifiers (doc)
• I-9 Remote Hire Notice Form (PDF)
• I-9 Remote Hire Instructions (PDF)

• Form W-4 (PDF) *New Form Available Soon - W-4 Communication (PDF)

• Form W-4 VT (PDF) is under revision. Please use PeopleSoft to make changes, or use the old form (PDF)
• Form W-11 (PDF) Hiring Incentives to Restore Employment (HIRE) Act

• Additional Pay Form (XLSX)
• FMLA Certification for Employee's Serious Health Condition (PDF)
• FMLA Certification for Family Member's Serious Health Condition (PDF)
• FMLA Tracking Spreadsheet (XLS)
• Flexible Working Arrangement Request Form (PDF)
• Leave of Absence Request (PDF)
• Overtime Voucher (PDF)
• Parental Leave Request - Faculty (PDF)
• Teaching Availability Form (Part-Time Faculty) (PDF)

• Social Security Tax Refund Certification (PDF) (refund of over-withheld Social Security)
• United Academics Dues Form (PDF)
• Voluntary Self-Identification of Disability (PDF)
• Voluntary Self-Identification of Protected Veterans (PDF) 
• Payroll Direct Deposit Compliance Form (PDF)
• Bonus Payment Request Form (XLSX)
• Voluntary Furlough Form (DOCX)

• BCBSVT Medical Enrollment/Change Request (PDF)
• Certification of Dependents (PDF)
• BCBS Coverage of Adult Dependent Request (PDF)
• Waiver of Medical Coverage (PDF)

• Delta Dental Enrollment/Change Request (PDF)
• Waiver of Dental Coverage (PDF)

• Vision Enrollment/Change Form (PDF)

• Flexible Spending Account Enrollment (PDF)
• FSA Reimbursement: Direct Deposit (PDF)
• Medical Expense Flexible Spending Claim (PDF)
• Dependent Care Flexible Spending Claim (PDF)
• EBPA Reimbursement Portal (scan the above UVM claim form and receipts, then upload)

• Group Life Insurance Enrollment/Change Form (PDF)
• Change of Beneficiary (PDF)
• Retiree Change of Beneficiary (PDF)
• Medical History Statement (PDF)

Enrollment Registration is ONLY Available During Open Enrollment

• Online Portal Instructions (PDF)

• Group Long-Term Disability Enrollment/Change Form (PDF)
• Medical History Statement (PDF)

• Tuition Remission Request Form (PDF)
• Tuition Remission Application for Part-time Represented Faculty (PDF)
• Tuition Remission Taxability for Graduate Courses (PDF)
• Tuition Remission Request Guide (PDF)

• 403(b) Retirement Plan Salary Reduction Agreement (PDF)
• 403(b) Retirement Catch-Up Option Request (PDF)
• 457(b) Salary Reduction Form/Participation Agreement (PDF)

• Fidelity 403(b) Enrollment (PDF)
• Fidelity 457(b) Enrollment (PDF)
• TIAA 403(b) Enrollment (PDF)
• TIAA 457(b) Enrollment (PDF)

• UVM's Retiree Health Savings Plan Election Form (PDF)

• BCBSVT Medical Enrollment/Change Request (PDF)
• Certification of Dependents (PDF)
• BCBS Coverage of Adult Dependent Request (PDF)
• Waiver of Medical Coverage (PDF)

• Delta Dental Enrollment/Change Request (PDF)
• Waiver of Dental Coverage (PDF)

• New Vision Enrollment/Change Form (PDF)

• Flexible Spending Account Enrollment for 2020 (PDF)
• FSA Reimbursement: Direct Deposit (PDF)
• Medical Expense Flexible Spending Claim (PDF)
• Dependent Care Flexible Spending Claim (PDF)
• EBPA Reimbursement Portal (scan the above UVM claim form and receipts, then upload)

• Group Life Insurance Enrollment/Change Form (PDF)
• Change of Beneficiary (PDF)
• Retiree Change of Beneficiary (PDF)
• Medical History Statement (PDF)

Enrollment Registration is ONLY Available During Open Enrollment

• Online Portal Instructions (PDF)

• Group Long-Term Disability Enrollment/Change Form (PDF)
• Medical History Statement (PDF)

• Tuition Remission Request Form (PDF)
• Tuition Remission Application for Part-time Represented Faculty (PDF)
• Tuition Remission Taxability for Graduate Courses (PDF)
• Tuition Remission Request Guide (PDF)

• 403(b) Retirement Plan Salary Reduction Agreement (PDF)
• 403(b) Retirement Catch-Up Option Request (PDF)
• 457(b) Salary Reduction Form/Participation Agreement (PDF)

• Fidelity 403(b) Enrollment (PDF)
• Fidelity 457(b) Enrollment (PDF)
• TIAA 403(b) Enrollment (PDF)
• TIAA 457(b) Enrollment (PDF)

• UVM's Retiree Health Savings Plan Election Form (PDF)

• Background Check: Forms & Information (PDF)
• Background Check: Request Form (PDF)
• Background Check: Disclosure Notice (PDF)
• Background Check: Acknowledgment & Authorization (PDF)
• Background Check: California Notice (PDF)
• Background Check: New York Notice (PDF)
• Background Check: Consumer Rights (PDF)
• Approval for Employment-Related Actions and Increases (XLSX)
• Approval for Employment-Related Actions and Increases (PDF)

• Position Description for Staff (doc)
• Reference Check for Job Applicants (doc)
• Exempt Staff Offer Letter Template (doc)
• Non-Exempt Staff Offer Letter Template (doc)
• Distribution Form (XLSX)
• Personnel Action Set-Up (XLSX)
• Termination Form (PDF)

Please visit the Temporary Employee & Paid Non-Employee Resources webpage for forms.

• Annual Employee Performance Review Form (Word)
• Annual Self-Review Form (Word)
• Performance Improvement Plan Process
• Performance Improvement Plan Form (PDF)