Faculty/Staff Forms
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New Hire Forms
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| Benefits Eligible New Hire Packet |
PDF |
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| Non-Benefits Eligible New Hire Packet |
PDF |
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| Employee's Tax Withholding Certificate (W-4) |
PDF |
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| Employment Eligibility Verification (I-9) |
PDF |
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| Workers Compensation Notice |
Word |
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Getting Paid at Rice
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| Timesheet - Bi-weekly, Non-Exempt |
Excel |
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| Academic Salary Option (9 vs. 12 month pay for faculty) |
Word |
PDF |
| Compressed Work Week Form |
PDF |
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| Employee's Tax Withholding Certificate (W-4) |
PDF |
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2012 Time & Attendance Forms
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| Exempt |
Excel |
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| Non-Exempt |
Excel |
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| Post Doc |
Excel |
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2011 Time & Attendance Forms
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| Exempt |
Excel |
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| Non-Exempt |
Excel |
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| Post Doc |
Excel |
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| Post Doc - Multiple Year Appointment |
Excel |
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Benefits
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| Aetna Medical Claim Form (PPO and Catastrophic plans) |
PDF |
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| Aetna Medical Claim Form (POS Non-Network benefits) |
PDF |
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| Orchard Mail Order Prescription Form |
PDF |
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| United Concordia Dental Claim Form |
PDF |
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| Dependent Care Spending Acct. Pay Me Back Form |
PDF |
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| Medical Spending Acct. Pay Me Back Form |
PDF |
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| Unum Short Term Disability Telephonic Brochure |
PDF |
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| Rice Retirement 401(a) Plan Administrator Selection Form |
PDF |
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403(b) Retirement Plan Salary Reduction Agreement
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PDF |
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| 457(b) Top-Hat Retirement Plan Salary Deferral Form |
PDF |
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Beneficiary Updates
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AD&D
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PDF |
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| Fidelity Investments Rice Retirement 401(a) Plan |
PDF |
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| Fidelity Investments 403(b) Plan |
PDF |
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| Life Insurance |
PDF |
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| TIAA-CREF (all plans) |
PDF |
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Tuition Benefits
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| Tuition Reimbursement Application Form |
PDF |
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| Tuition Remission for Dependents Application Form |
PDF |
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| Tuition Waiver Application Form |
PDF |
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| Tuition Waiver (Spouse/Domestic Partner) Form |
PDF |
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Other Faculty/Staff Forms
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| Common Law Marriage Affidavit |
PDF |
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| Consent to Release Employment Information |
PDF |
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| Domestic Partner Registration Packet |
Word |
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| Primary Caregiver Leave Affidavit |
PDF |
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| Personal Data Form |
PDF |
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| Complimentary Personal Data Form |
PDF |
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FMLA Forms
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Certification of Health Care Provider for Employee's Serious
Health Condition
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PDF |
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Certification of Health Care Provider for Family Member's
Serious Health Condition |
PDF |
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| Certification of Qualifying Exigency for Military Leave |
PDF |
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Certification for Serious Injury or Illness of Covered
Service Member -- for Military Family Leave |
PDF |
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Leaving Rice
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| Voluntary Resignation Form |
Word |
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| Check Out Form |
PDF |
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| Exit Interview Summary Form |
PDF |
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Department/Manager Forms
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Candidate and New Hire Forms
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| Affirmative Action for Faculty & Post-Docs |
PDF |
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Approval to Initiate H-1B Visa Application for Staff
Employees |
PDF |
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| Background Check Release Form (ARF)-Temporary Staff |
PDF |
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| Background Check Release Form (ARF) |
PDF |
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| Character Reference Form |
Word |
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| Employer-Sponsored Permanent Residency for Faculty |
PDF |
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| Employer-Sponsored Permanent Residency for Staff |
PDF |
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| Personnel Action Form |
PDF |
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| Personal Data Form |
PDF |
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| Recommendation for Appointment Form |
PDF |
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Current Employee Changes
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| Leave of Absence Form |
PDF |
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| Personnel Action Form |
PDF |
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| Personal Data Form |
PDF |
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Performance
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| Performance Appraisal |
Word |
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| Self Evaluation Form |
Word |
PDF |
| Counseling Record |
PDF |
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Compensation
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Job Description Summary for Staff Market Salary Review
Request |
Word |
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Job Description Summary - Request for an Exempt Temp
Position
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Word |
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| Staff Market Salary Review Request Form |
Word |
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| RICEWorks Job Description Template |
Word |
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Leaving Rice
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| Termination Form |
Word |
PDF |
| Voluntary Resignation Form |
Word |
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| Check Out Form |
PDF |
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Other Requests
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| Label Request Form |
Web |
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| Compressed Work Week Form |
PDF |
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