Forms

Payroll and Benefit Change Forms:

• Change of Address forms [PDF] - must submit both forms if an APERS participant
• Change of Beneficiary Form: Arkansas Public Employees Retirement [PDF]
• Change of Name forms [PDF] - must submit both forms
• Direct Deposit Change Form [PDF]
• Telcoe Credit Union Enrollment/Change form
• Uark Credit Union Enrollment/Change form
• 2013 Federal Tax Withholding Form W-4
• State of Arkansas Tax Withholding Form
• Workers Compensation: Employee's Notice of Injury [PDF] - Form N: To be completed by Employee

FMLA Forms:

•  Certification of Health Care Provider for Employee [PDF]
• Certification of Health Care Provider for Family Member [PDF]
• Certification of Qualifying Exigency - Military [PDF]
• Certification of Serious Injury of Military Service Member [PDF]

 Forms for Supervisors

• Performance Evaluation Form
• Performance Recognition Form [PDF]
• Performance Improvement Plan [PDF]
• Statement of Personal Use of County Owned Vehicle [PDF]
• Workers Compensation: First Report [PDF] - to be completed by Supervisor