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HR E-Forms for CRT
➤ Attendance / Leave ➤ Benefits ➤ CPTP
➤ Drug Testing ➤ New Hire ➤ Orientation
➤ PES ➤ Personal Data ➤ Personnel Action
➤ Position Description ➤ Pre-Employment ➤ Recruitment
➤ Retirement ➤ Safety ➤ Lasers

Attendance/Leave
Work Schedule Form revised 10/2012 Work Schedule Form -
Unscheduled Absenteeism Violation Form revised 3/2014 Unscheduled Absenteeism Violation Form -
PTMW Quick Reference Guide revised 2/2016 - PTMW Quick Reference Guide
Prior Pay Period Adjustment form - Prior Pay Period Adjustment Form

Benefits
Websites for Benefits Providers web page word_icon.png
LASERS Forms
Designation of Beneficiary - Designation of Beneficiary
Membership Registration
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification.
- Membership Registration
01-13 Benefit Forfeiture - 01-13 Benefit Forfeiture
LA Deferred Compensation
Deferred Compensation Benefits - 01-13 Benefit Forfeiture
2016 SDA and Enrollment Form - 01-13 Benefit Forfeiture
Office of Group Benefits Forms
2016 Flexible Benefits Enrollment Form - 2016 Flexible Benefits Enrollment Form
Flexible Benefits Plan - Flexible Benefits Plan
Options for Health Insurance Coverage (Affordable Care Act) Notice - Options for Health Insurance Coverage (Affordable Care Act) Notice
Affordable Care Act Acknowledgement Form - Affordable Care Act Acknowledgement Form
2016 OGB Medical Benefits Comparison for Active Employees and Non-Medicare Retirees - benefit comparison
January 2016 Premium Rates - July 2015 Premium Rates
GB-01 Enrollment Change Form - 2014 GB-01 Enrollment Change Form
HSA Payroll Election Form - HSA Payroll Election Form
Life Insurance Beneficiary Change Form - Life Insurance Beneficiary Change Form
Life Insurance Enrollment Kit - Life Insurance Enrollment Kit

CPTP
Mandatory Training Class (by Supervisory Group) revised 11/8/2011 - Mandatory Training Class (by Supervisory Group)
Mandatory Training Position Title List web page

Drug Testing
Notification of Drug Testing Period Form - for New Employees - revised 1/2016 Notification of Drug Testing Period Form WORD -
Drug Testing Sites in Louisiana revised 12/29/2015
- Drug Testing Sites in Louisiana
Notification of Random Testing Period - for EXISTING Employees Only - revised 1/2016 form -

New Hire
Conditional Offer of Employment Form revised 1/2016 Conditional Offer of Employment Form -
Authorization for Criminal Background Check form - background check form
Employment in a Non-Permanent Job Appointment - Statement of Agreement and Understanding - pdf_icon.png
Employment in a Non-Permanent WAE Appointment - Statement of Agreement and Understanding - Employment in a Non-Permanent WAE Position Form
New Hire Packet Checklist revised 8/2016 New Hire Packet Checklist -
SF-13 Appointment Affidavits revision 5/2003 SF-13 Appointment Affidavits -
Civil Service Rule 6.5g Hiring Rate Request Form Civil Service Rule 6.5g Hiring Rate Request Form -

Orientation
Remote Hiring Manager Orientation Packet revised 8/2016 webpage

Performance Evaluation System - Evaluation Forms
PES Forms and Instructions webpage

Personal Data
Change of Address Change of Address Change of Address
Direct Deposit Primary Account - Direct Deposit Primary Account
Direct Deposit Secondary Account - Direct Deposit Secondary Account

Personnel Action
Optional Pay Adjustment Questionnaire Optional Pay Adjustment Questionnaire -
Personnel Authorization Form (301) revised 5/15 Personnel Authorization Form (301) -
Permanent Status Consideration Form Permanent Status Consideration Form -
Career Progression Group Consideration Form Career Progression Group Consideration Form -

Position Description
SF3 revised 5/2016 SF3 -
SF3a SF3a SF3
SF3 Instructions SF3 Instructions SF3a
Classified WAE Position Description Classified WAE Position Description -

Pre-Employment
State Employment Advantage and Responsibilities - State Employment Advantage and Responsibilities
Some of the Benefits of Working in Louisiana State Government - Some of the Benefits of Working in Louisiana State Government
Confidentiality of Home Address & Phone Number Confidentiality of Home Address & Phone Number Confidentiality of Home Address & Phone Number
Compensation for Overtime Work Compensation for Overtime Work -
Direct Deposit Primary Account - Direct Deposit Primary Account
Direct Deposit Secondary Account - Direct Deposit Secondary Account
Driver History Form (DA 2054) revised 7/01/2012 - Driver History Form (DA 2054)
I-9 Form revised 3/08/2013 - I-9 Form
Prior State Service Prior State Service Prior State Service
L-4 Tax Form (Louisiana) - L-4 Tax Form (Louisiana)
SSA-1945 - SSA-1945
W-4 Tax Form (2016 Federal) - 2016 W-4

Recruitment
Request to Fill Position Form new 10/8/2013 Request to Fill Position Form OnBase Workflow Document Instructions
Application for Outside Employment new 4/30/2014 Application for Outside Employment OnBase Workflow Document Instructions
Student Employment Application Student Employment Application -

Retirement
LASERS Forms
4-05 Authorization for Direct Deposit - 4-05 Authorization for Direct Deposit
4-4 Spousal Consent - 4-4 Spousal Consent
6-01 Application For Retirement
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 6-01 Application For Retirement
6-01A Application For Retirement with IBO
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 6-01A Application For Retirement with IBO
6-2 Insurance Premium Deduction Authorization
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 6-2 Insurance Premium Deduction Authorization
9-01 Application for Deferred Retirement Option Plan (DROP)
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 9-01 Application for Deferred Retirement Option Plan (DROP)
9-02 Certification at End of Employment
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 9-02 Certification at End of Employment
9-02A Certification of Continued Employment After DROP
*Upon completion by the employee, this form must be forwarded to the Human Resources Division for certification prior to submitting it to LASERS.
- 9-02A Certification of Continued Employment After DROP
Federal Forms
W4-P (2016) - W4-P

Safety
General Safety Rules - Medical Release Form
Medical Release Form Medical Release Form Medical Release Form
Workers Compensation Medical Authorization Form Workers Compensation Medical Authorization Form Workers Compensation Medical Authorization Form
Vehicle Non-State Employee Rider (passenger) Indemnification Agreement Vehicle Non-State Employee Rider (passenger) Indemnification Agreement Vehicle Non-State Employee Rider (passenger) Indemnification Agreement

LASERS Forms
2-01 Refund of Accumulated Contributions - 2-01 Refund of Accumulated Contributions