Forms

Most of these forms are in Portable Document Format (PDF) with fields to be filled out on-line using Adobe Acrobat Reader version 7.0 or later. These PDF forms should then be printed using the printer icon near the upper-left corner of the form. Some of these PDF forms can be saved when completed. but your PC must have Adobe Reader 7.0 or higher installed.

• All Forms
  • Benefits
    • UVa Health Plans
    • Vision Insurance
    • Flexible Spending Accounts
    • Life and AD&D Insurance
    • Medical Leave
    • VRS Forms
    • ORP, MCRP, TDSP and Cash Match
    • Medex Forms
    • Workers’ Compensation Forms
  • Compliance and Immigration
    • Selective Service Form
    • I-9 Forms - ONLY FOR REMOTE USE
    • Immigration Forms
  • Compensation Management
    • Earnings Element Request (PDF)
    • Pay Action Request (PDF)
    • Position Action Form (PDF)
    • Position Action Appeal (DOC)
    • Recognition Award Request (PDF)
  • Education Benefits
    • Education Benefits Enrollment Form (EXTERNAL)
  • Employee Records
    • Faculty Salaried Personnel Hire Form (PDF)
    • Faculty Wage/Student Personnel Hire Form (PDF)
    • Name/Address Change (PDF)
    • Removal of Access Privileges (DOC)
  • Essential WorkSkills Nomination Form (PDF)
  • Faculty & Staff Relations
    • Acknowledgment of Restricted Classified Staff Employment (PDF)
    • Acknowledgment of Restricted University Staff Employment (PDF)
    • Conditions of Employment Acknowledgment for Classified Staff (PDF)
    • Conditions of Employment Acknowledgment for University Staff (PDF)
    • Exceptional Performance Form (PDF)
    • Fitness for Duty – Initial Observation Report (PDF)
    • Family Medical Leave (FMLA) Form (PDF)
    • Notice of Improvement Needed (PDF)
    • Outstanding Contributors Award Nomination (PDF)
    • Written Notice Form (DOC)
  • Leave
    • Emergency & Disaster Leave Form (PDF)
    • Ill Health Certification (PDF)
    • Leave Sharing Donor Application (PDF)
    • Leave Sharing Recipient Application (PDF)
    • Request for Overtime Leave Payment (PDF)
    • Family Medical Leave (FMLA) Form (PDF)
  • Payroll
    • Direct Deposit Enrollment (PDF)
    • Moving Agreement (Revised Oct 2011) (PDF)
    • Post-Doctoral Fellow Direct Deposit Form (PDF)
    • Time Management Form (PDF)
    • Time Management Form - Shift Work (PDF)
    • VA-4 Form (PDF)
    • W-4 and VA-4 Taxes (PDF)
  • Performance Management
    • Exceptional Performance Form (PDF)
    • Exceptional Performance Form (DOC)
    • Notice of Improvement Needed (PDF)
    • Probationary Progress Review/Extension/Completion Form (PDF)
  • Recruitment and Staffing
    • Departmental Orientation Checklist (PDF)
    • Dual Employment Request (DOC)
    • Executive Staff Offer Letter Template (PDF)
    • Reassignment Request (PDF)
    • Request for Exemption from Hiring Freeze (PDF)
• Benefits
• Compensation Management
• Compliance and Immigration
• Education Benefits
• Employee Records
• Faculty & Staff Relations
• Leave
• Payroll Forms
• Performance Management
• Recruitment and Staffing
  • Selective Service Compliance
  • Selective Service
• Privacy Notice