State of Alaska, Department of Administration, Division of Personnel and Labor Relations

Employee Form Packets


Packet Form Requirement
Board and Commission Members Hire Packet

Reminder: In accordance with AS 39.50.020, members of certain boards and commissions and other “public officials” as defined under AS 39.50.200 are required to file a Public Official Financial Disclosure (POFD) within 30 days of appointment.

Personnel Action Request Form (PARF) PDF/Excel Mandatory
Acknowledgment Form Mandatory
Employment Eligibility Verification (I-9) Mandatory
Employee Withholding Allowance (W-4) Mandatory
Address Authorization Mandatory
Payroll Direct Deposit Form
Designation of Beneficiary for Unpaid Compensation Mandatory
Alaska Supplemental Annuity Plan Beneficiary Designation Mandatory
Attendance Sheet Mandatory
Social Security Form (SSA-1945) Mandatory
Board and Commission Members Separation Packet

Reminder: In accordance with AS 39.50.020, members of certain boards and commissions and other “public officials” as defined under AS 39.50.200 are required to file a final Public Official Financial Disclosure (POFD) within 90 days of leaving state service.

Personnel Action Request Form (PARF) PDF/Excel Mandatory
Address Authorization/Change Form Mandatory
SBS Annuity Election Form Mandatory
Attendance Sheet Mandatory
Current State Employee Position Change (Transfer, etc.)
Current Employee Forms Supervisor Checklist Optional
Address Authorization/Change Form Optional

Statewide Policies

The following are the Administrative Orders that you are required to read. The signature form needs to be printed and signed, acknowledging that the employee has read the information.

 Mandatory
Basic & Select Life Insurance Enrollment or Change Form Optional
Beneficiary Forms
(includes "Designation of Beneficiary for Unpaid Compensation")		 Optional
Confidentiality of Information Acknowledgement Form
 Mandatory
Payroll Direct Deposit Form
Drug Free Workplace Act of 1988 Mandatory
Employee Affidavit Oath of Office Mandatory
Employee Clearance Form Mandatory
Ethics Disclosure: Outside Employment or Services Notification (if applicable) Mandatory
W-4 Form (Employee Withholding Allowance Certificate) Optional
GGU Health Trust Information Form (GGU Only) (BU Change) Mandatory
LTC Health Trust Notification Form (LTC Only) Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Pre-Employment Certification Form Mandatory
Retirement Beneficiary Designation Form (PERS/TRS) Optional
SBS/AlaskaCare Enrollment Packet   ENROLL NOW (On line enrollment required) Optional
Supervisor Guide to New Employee Orientation Optional
Union Notification Form (BU Change) OR Union Notification for ASEA (GGU) Mandatory
Exempt and Partially Exempt (EX and PX) Hiring Packet [back to top]

Reminder: In accordance with AS 39.50.020, members of certain boards and commissions and other “public officials” as defined under AS 39.50.200 are required to file a Public Official Financial Disclosure (POFD) within 30 days of appointment.
Address Authorization/Change Mandatory
Alaska Supplemental Annuity Plan Beneficiary Designation Mandatory
Basic & Select Life Insurance Enrollment/Change Form Mandatory
Confidentiality of Information Acknowledgement Form Mandatory

Defined Contribution or Defined Benefits Retirement Plan Beneficiary Designation Form (PERS/TRS) - Complete instructions are on these forms; verify that percentage total equals 100%. Employee signature/date and witness signature/date required. The completed forms must be forwarded to R&B to be considered a valid designation.

PERS Tier IV / TRS Tier III employees complete the following forms if first appointed to a PERS/TRS position on or after 07/01/06.

or

PERS Tier I/II/III / TRS Tier I/II employees appointed to a PERS/TRS position prior to 07/01/06 complete the following form:

 Mandatory
Designation of Beneficiary For Unpaid Compensation Mandatory
Payroll Direct Deposit Form
Drug-free Workplace Act Mandatory
Employee Affidavit Oath of Office Mandatory
Employee Withholding Allowance (W-4) Mandatory
Employee Eligibility Verification (I-9) Mandatory
Ethics Disclosure: Outside Employment or Services Notification (if applicable) Mandatory
Equal Employment Opportunity Survey Mandatory
Nepotism Waiver Optional
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Pre-employment Certification Form Mandatory
Prior Service Verification (if applicable) Mandatory
Post Hire Questionnaire for Second Injury Fund Qualification Mandatory
Social Security Form (SSA-1945) Mandatory

Statewide Policies

The following are the Administrative Orders that you are required to read. The signature form needs to be printed and signed, acknowledging that the employee has read the information.

 Mandatory
SBS/AlaskaCare Enrollment Packet   ENROLL NOW (On line enrollment required) Mandatory
GGU Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
Separating Employee Health Insurance Notice
GGU Health Trust Notification Form Mandatory
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
TRS Claim and Verification of Unused Sick Leave Credit Optional
IBU Separating [back to top]
IBU Separation Cover Letter Mandatory
Letter of resignation Mandatory
Employee Clearance Form Mandatory
Exit Survey
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
PERS / TRS Refund Election Optional
Annuity Benefit Election Form (SBS) Optional
W4-P (Withholding Certificate for Pension or Annuity Payments) Optional
KK Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
LTC Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
LTC Health Trust Notification Form (LTC Only) Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
MEBA Separating [back to top]
MEBA Separation Cover Letter Mandatory
Letter of resignation Mandatory
Employee Clearance Form Mandatory
Exit Survey
Separating Employee Health Insurance Notice
Leaving State Employment Handbook Optional
Annuity Benefit Election Form (SBS) Optional
W4-P (Withholding Certificate for Pension or Annuity Payments) Optional
MMP Separating [back to top]
MMP Separation Cover Letter Mandatory
Letter of resignation Mandatory
PERS / TRS Refund Election Optional
Exit Survey
Separating Employee Health Insurance Notice
Annuity Benefit Election Form (SBS) Optional
Leaving State Employment Handbook Optional
Employee Clearance Form Mandatory
PSEA Separating [back to top]
Address Authorization/Change Form Optional
Separating Employee Health Insurance Notice
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
Exempt and Partially Exmpt (EX and PX) Separating [back to top]

Reminder: In accordance with AS 39.50.020, members of certain boards and commissions and other “public officials” as defined under AS 39.50.200 are required to file a final Public Official Financial Disclosure (POFD) within 90 days of leaving state service.
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
TRS Claim and Verification of Unused Sick Leave Credit Optional
SU Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
TRS Claim and Verification of Unused Sick Leave Credit Optional
Troopers Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS / TRS Refund Election Optional
PERS Spouse's Consent to Refund Optional
Public Employees' Retirement System (PERS) Information Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
Transfer out of Dept [back to top]
Employee Clearance Form Mandatory
Exit Survey
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Timesheet Mandatory
Long Term Non Perm Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
GGU Health Trust Notification Form (GGU Only) Mandatory
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
LTC Health Trust Notification Form (LTC Only) Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
Term Leave Payoff Tax Option Form Optional
Timesheet Mandatory
TRS Claim and Verification of Unused Sick Leave Credit Optional
Short Term Non Perm Separating [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Checkoff List for Separating Employees Optional
Employee Clearance Form Mandatory
Exit Survey
W-4 Form Optional
Leaving State Employment Handbook Optional
Letter of Resignation Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Coversheet Optional
Timesheet Mandatory
To Seasonal Leave Without Pay [back to top]
Employee Clearance Form Mandatory
Address Authorization/Change Form Optional
Separating Employee Health Insurance Notice
Basic & Select Life Insurance Enrollment Form or Change Form Optional
Beneficiary Forms Optional
Deferred Compensation and other changes Optional
Designation of Beneficiary for Unpaid Compensation Optional
GGU Health Trust Notification Form (GGU Only) Mandatory
LTC Health Trust Notification Form (LTC Only) Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Performance Evaluation Optional
PERS Beneficiary Designation Optional
Optional Benefits Beneficiary Form (02-1841) Optional
Seasonal Employee Leave Retention GGU/LTC/SU Mandatory
Timesheet Mandatory
Return From Seasonal Leave Without Pay [back to top]
Address Authorization/Change Form Optional
GGU Health Trust Notification Form (GGU Only) Mandatory
LTC Health Trust Notification Form (LTC Only) Mandatory
Basic & Select Life Insurance Enrollment or Change Form Optional
Payroll Direct Deposit Form
W-4 Form (Employee Withholding Allowance Certificate) Optional
GGU Overtime/Compensatory Time Option Form Optional
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Retirement Beneficiary Designation Form (PERS/TRS) Optional
SBS/AlaskaCare Enrollment Packet   ENROLL NOW (On line enrollment required) Optional
Timesheet Optional
GGU Health Trust Insurance Deferral (GGU Only) Optional
Status Change [back to top]
(Marriage/Divorce/Birth of a Child/Employment Status Change/Name Change)
Marriage Certificate / Divorce Decree / Birth Certificate
(whichever is applicable)		 Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Social Security Application (Mandatory for Name Change Only) Mandatory

Address Authorization/Change Form
Optional
Basic & Select Life Insurance Enrollment Form or Change Form Optional
Beneficiary Forms Optional
Deferred Compensation and other changes Optional
Designation of Beneficiary for Unpaid Compensation Optional
Payroll Direct Deposit Form Optional
Employee Affidavit (02-024) Optional
GGU Health Trust Notification Form (GGU Only) Optional
LTC Health Trust Notification Form (LTC Only) Optional
SBS/AlaskaCare Enrollment Packet   ENROLL NOW (On line enrollment required) Optional
W-4 Form Optional
Family Medical Leave [back to top]
Conditional Family Leave Notification Optional
Your Rights Under the Family and Medical Leave Act of 1993 Mandatory
Certification of Health Care Provider Mandatory
Layoff [back to top]
Address Authorization/Change Form Optional
Annuity Benefit Election Form (SBS) Optional
Separating Employee Health Insurance Notice
COBRA Health Continuation for AlaskaCare Optional
Conditions of Employment Upon Return From Layoff (GGU and SU) Mandatory
Employee Clearance Form Mandatory
Exit Survey
GGU Health Trust Notification Form (GGU Only) Mandatory
Leaving State Employment Handbook Optional
LTC Health Trust Notification Form (LTC Only) Mandatory
Personnel Action Request Form (PARF) PDF/Excel
To Military Leave [back to top]
Address Authorization/Change Form Optional
Beneficiary Forms Optional
Copy of Military Orders Mandatory
Employment Clearance Form Mandatory
Military Leave Benefit Election Form Mandatory
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Timesheet Mandatory
W-4 Optional
Return from Military Leave [back to top]
Address Authorization/Change Form Optional
Beneficiary Forms Optional
Personnel Action Request Form (PARF) PDF/Excel Mandatory
Timesheet Mandatory
W-4 Optional