{"id":1558,"date":"2018-02-22T15:21:39","date_gmt":"2018-02-22T15:21:39","guid":{"rendered":"https:\/\/wptest.mdek12.org\/testsite2\/human-resources-documents\/"},"modified":"2024-10-21T16:09:37","modified_gmt":"2024-10-21T16:09:37","slug":"human-resources-forms","status":"publish","type":"page","link":"https:\/\/wpdev01.mdek12.org\/humanresources\/human-resources-forms\/","title":{"rendered":"Human Resources Forms"},"content":{"rendered":"<p><a href=\"http:\/\/www.mspb.ms.gov\/\">Submit Employment Application<\/a><br \/>\nYou may complete an online application\u00a0<a href=\"http:\/\/www.mspb.ms.gov\/\">here<\/a>. You may apply for jobs 24\/7.<\/p>\n<ul>\n<li><a href=\"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-content\/uploads\/sites\/25\/2024\/01\/2024_w4.pdf\">2024\u00a0W-4 Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/ad-hoc_telecommuting_arrangments_8.23_004_002.pdf\">AD-HOC Telecommuting Arrangements<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/applicant-summary.pdf\">Applicant Summary<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/authorization_for_release_of_information_20201201.pdf\">Authorization for Release of Information<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/Cafeteria%20Plan%20Reimbursement%20Form.pdf\">Cafeteria Plan Reimbursement Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/chronic_form-rev.pdf\">Chronic Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/direct_deposit_form_rev.pdf\">Direct Deposit Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/mde-donated-leave-form-link-3.pdf\">Donated Leave Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/eap_employee_assistance_program.pdf\">Employee Assistance Program<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/entryexitchecklistformrevisedjanuary012020hr.pdf\">Entry and Exit Checklist<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/work-schedule-request-form_20170706091623_559740.pdf\">Flex Time Work Schedule Request Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/fmla_certification_form_employee.pdf\">FMLA Certification Form (Employee)<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/fmla_certification_form_family_member.pdf\">FMLA Certification Form (Family Member)<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/i-9.pdf\">Form I-9, Employment Eligibility Verification<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/p1_20211013.pdf\">Form P-1, &#8220;Request to Recruit for Employment&#8221;<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/p2_1promotion_transfer_request_20211013.pdf\">Form P-2, &#8220;Employment, Promotion or Transfer Request&#8221;<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/formp3_20211013.pdf\">Form P-3, &#8220;Termination of Employment&#8221;<\/a><\/li>\n<li><a href=\"https:\/\/www.eab.ms.gov\/sites\/eab\/files\/EAB-Templates\/MSPB Grievance Form.pdf\">MSPB Grievance Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/health-insurance-application_20170814124117_921915.pdf\">Health Insurance Plan Application for Coverage<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/leave_form.pdf\">Leave Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/MDE%20Contract%20Worker%20Background%20Acknowledgement.pdf\">MDE Contract Worker Background Acknowledgement<\/a><\/li>\n<li><a href=\"https:\/\/www.mdek12.org\/sites\/default\/files\/documents\/Human%20Resources\/New-Hire-Packet.pdf\">MDE New Hire Packet<\/a><\/li>\n<li><a href=\"https:\/\/www.mdek12.org\/sites\/default\/files\/documents\/Human%20Resources\/mspb_handbook_and_acknolwedgement_form.pdf\">MSPB handbook and acknowledgement form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/updated_state_tax_form.pdf\">Mississippi State Tax Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/time-sheet-single-page-print-rev-3-31-20.xlsx\">Monthly Time Report<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/non-state_service_letter_004.docx\">Non-State Service Letter<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/certification-for-donated-leave-link-1.pdf\">Physicians&#8217; Certification for Donated Leave<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/request-for-donated-leave-link-2.pdf\">Request for Donated Leave<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/telephone-reference-check.pdf\">Telephone Reference Check<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/telework_assignment_form.pdf\">Telework Assignment Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/mde_workers_comp_packet.pdf\">Workers&#8217; Compensation Packet<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h4><strong>PERS<\/strong><\/h4>\n<ul>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/PERS%20Beneficiary%20Designation%20Form.pdf\">PERS Beneficiary Designation<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/PERS%20Change%20of%20Information%20Form.pdf\">PERS Change of Information<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/PERS%20Membership%20Application.pdf\">PERS Membership Application<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h4><strong>COMPLIANCE FORMS<\/strong><\/h4>\n<ul>\n<li><a href=\"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-content\/uploads\/sites\/25\/2024\/05\/fraud_waste_abuse_policy_acknowledgment_new.pdf\">Fraud Waste &amp; Abuse Policy Acknowledgment<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/code-of-ethical-conduct-policy-acknowlegment.pdf\">Code of Ethical Conduct Policy Acknowledgment<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/code-of-ethical-conduct-policy-for-accounting-finance-employees-acknowledgment.pdf\">Code of Ethical Conduct Policy for Accounting &amp; Finance Employees Acknowledgment<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/related-party-and-nepotism-acknowledgment.pdf\">Related Party and Nepotism Acknowledgment<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/related-party-questionnaire_20170713151059_552037.pdf\">Related Party Questionnaire<\/a><\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h4><strong>CONTRACT WORKER FORMS<\/strong><\/h4>\n<p><strong>FORMS TO BE COMPLETED BY CONTRACT WORKER<\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-content\/uploads\/sites\/25\/2024\/01\/2024_w4.pdf\">2024\u00a0W-4 Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/updated_state_tax_form.pdf\">Mississippi State Tax Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Procurement\/Contract%20Worker%20Checklist%208%209%202018\/Current%20PERS%20Certification%20.doc\">Certification of PERS Service Retirement<\/a>\u00a0The SBE must approve contracts with former state employees who are PERS retirees receiving retirement benefits for an amount exceeding $20,000 a year.<\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Procurement\/Contract%20Worker%20Checklist%208%209%202018\/direct_deposit_form.pdf\">Direct Deposit Form<\/a><\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Procurement\/Contract%20Worker%20Checklist%208%209%202018\/cw_info_change_form.pdf\">Information Change Form\u00a0<\/a>&#8211; Name, Address, etc.<\/li>\n<\/ul>\n<p><strong>FORMS TO BE COMPLETED BY CONTRACT WORKER AND REQUESTING OFFICE:<\/strong><\/p>\n<ul>\n<li><a href=\"http:\/\/www.pers.ms.gov\/Content\/Pages\/Forms.aspx\">PERS Form 4B\u00a0<\/a>(only complete if contract worker is a PERS retiree)<\/li>\n<li><a href=\"https:\/\/www.uscis.gov\/i-9\">Form I-9<\/a>\u00a0&#8211; Employment Eligibility Verification<\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/MDE%20Contract%20Worker%20Background%20Acknowledgement.pdf\">Background Acknowledgement and Authorization to Release Information<\/a>\u00a0(with Human Resources approval)\u00a0Note: If there is not a break in service from the prior fiscal year then no additional background check is required. However, if there is a break in service, then another background check is required.<\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Human%20Resources\/telephone-reference-check.pdf\">Telephone Reference Check<\/a>, Please complete this form for each reference check done on behalf of the candidate.<\/li>\n<li><a href=\"\/sites\/default\/files\/documents\/Procurement\/Inpendendent%20Contract%20Checklist%208%209%202018\/contractordistrictacknowledgementform%209.13.18.doc\">Certification of School District\/Public Entity<\/a><a href=\"\/sites\/default\/files\/documents\/Procurement\/contractordistrictacknowledgementform.doc\">\u00a0<\/a>\u00a0(Only complete if contractor is a school district or public entity employee.)\u00a0\u00a0 Form to be completed by contractor and requesting office.\u00a0 The form can be modified if employment is other than a school district.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Submit Employment Application You may complete an online application\u00a0here. You may apply for jobs 24\/7. 2024\u00a0W-4 Form AD-HOC Telecommuting Arrangements Applicant Summary Authorization for Release of Information Cafeteria Plan Reimbursement Form Chronic Form Direct Deposit Form Donated Leave Form Employee Assistance Program Entry and Exit Checklist Flex Time Work Schedule Request Form FMLA Certification Form [&hellip;]<\/p>\n","protected":false},"author":14,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-1558","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/pages\/1558"}],"collection":[{"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/comments?post=1558"}],"version-history":[{"count":5,"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/pages\/1558\/revisions"}],"predecessor-version":[{"id":2190,"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/pages\/1558\/revisions\/2190"}],"wp:attachment":[{"href":"https:\/\/wpdev01.mdek12.org\/humanresources\/wp-json\/wp\/v2\/media?parent=1558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}