Webmail Phone List
5/16/2022
Major Menus LEO OnBase OnBase Mobile Google
HR E-Forms for CRT
➤ Attendance / Leave ➤ ADA ➤ 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 2/2019 - Work Schedule Form
Unscheduled Absenteeism Violation Form revised 3/2014 Unscheduled Absenteeism Violation Form -
PTMW Quick Reference Guide revised 2/2021 - PTMW Quick Reference Guide
Prior Pay Period Adjustment form - Prior Pay Period Adjustment Form

Americans with Disabilities Act
Medical Inquiry Form - pdf_icon.png
Request for Accommodation Form - Request for Accommodation Form pdf

Benefits
Websites for Benefits Providers word_icon.png -
LASERS Forms
01-06 Designation of Beneficiary - Designation of Beneficiary
01-01 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 - Deferred Compensation Benefits
Online Enrollment Procedures - Deferred Comp Online Enrollment Procedure PDF
Office of Group Benefits Forms
2022 Flexible Benefits Enrollment Form - 2022 Flexible Benefits Enrollment and Stop Form
Flexible Benefits Plan webpage
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
2022 OGB Medical Benefits Comparison for Active Employees and Non-Medicare Retirees - benefit comparison
January 2022 Premium Rates - January 2022 Premium Rates
GB-01 Enrollment Change Form - 2014 GB-01 Enrollment Change Form
HSA Payroll Election Form (GB-79) - GB-79 Health Savings Account Enrollment and Payroll Deduction Election - Changeform pdf
Life Insurance Beneficiary Change Form - Prudential Life Insurance Beneficiary Change Form
Life Insurance Enrollment Kit - Life Insurance Enrollment Kit

CPTP
Mandatory Training Class (by Supervisory Group) - 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 -
Authorization Form for Drug Testing - Drug Testing Authorization Form PDF
Drug Testing Sites in Louisiana revised 6-13-2019
- Drug Testing Sites in Louisiana
Notification of Random Testing Period - for EXISTING Employees Only - revised 1/2016 form -

New Hire
Authorization for Criminal Background Check form - background check form
Employment in Understanding a Non-Permanent Appointment (Job Appointment / WAE) Statement of Agreement and Understanding - pdf_icon.png
SF-13 Appointment Affidavits revision 2/2019 - SF-13 Appointment Affidavits PDF
Civil Service Rule 6.5g Hiring Rate Request Form - Civil Service Rule 6.5g Hiring Rate Request Form
Work Permit for Minors - Work Permit for Minors

Orientation
Remote Hiring Manager Orientation Packet revised 9/2019 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
Personnel Authorization Form (301) revised 1/31/2019 Personnel Authorization Form 301 - OnBase Workflow -
Permanent Status Consideration Form - ermanent Status Consideration Form
Career Progression Group Consideration Form Career Progression Group Consideration Form -
SF-14 - Resignation and Exit - SF-14 - Resignation and Exit PDF

Position Description
SF3 revised 7/2021 - SF3
Physical Requirements SF-3 Attachment SF3 -
SF3a SF3a SF3
SF3 Instructions SF3 Instructions SF3a
Classified WAE Position Description revised 10/2018 Classified WAE Position Description -

Pre-Employment
Full-Time New Hire Forms for Completion updated 4/26/2022 - Full-Time New Hire Forms for Completion PDF
New WAE Hire Packet updated 4/28/2022 - New WAE Hire Packet PDF
Personal Data Form - Personal Data Form PDF
Compensation for Overtime Work - Compensation for Overtime Work PDF
Driver History Form (DA 2054) revised 7/01/2012 - Driver History Form (DA 2054)
I-9 Form revised 6/2020 - 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 (2022 Federal) - 2021 W-4
Education Request Form - 2021 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- Please contact Human Resources for retirement packets.
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. Additional forms required.
- 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. Additional forms required.
- 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. Additional forms required.
- 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. Additional forms required.
- 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 (2022) - W4-P

Safety
General Safety Program - General Safety Program
Assignment of Safety Responsibility - Assignment of Safety Responsibility
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 or Passenger Indemnification Agreement

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