Forms

Most Popular Forms

401(k) Payroll Changes Participation Agreement
457 Payroll Changes Participation Agreement

Assistant District Attorney Application
Investigator Application

Secretary Application

Georgia Hotel and Motel Tax Exemption

Out of State Travel Authorization

State Travel Reimbursement Form (2016)
State Travel Reimbursement Form (2017)

W9

Victim Impact Restitution Form
Employee Information Sheet (PDF)
Employee Information Sheet (This editable WORD file is very large)
Statement of Limitation of Practice (for Part-Time Solicitors-General)
Payment & Reimbursement Request (for PAC Atlanta use ONLY)

Family and Medical Leave Act Forms

FMLA Form
Certification of Health Care Provider for Employee's Serious Health Condition
Certification of Health Care Provider for Family Member's Serious Health Condition
Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
Certification for Serious Injury of a Current Servicemember
Certification of Qualifying Exigency for Military Family Leave
Standard Disability Benefit Claim Form

HR Workplace Posters

1 - EEOC
2 - Federal Minimum Wage
3 - FMLA
4 - OSHA
5 - Unemployment Insurance
6 - USERRA Private
7 - E-Verify
8 - WC Fraud
9 - WC Bill of Rights
10 - Reporting of Injuries
11 - Child Labor Summary Sheet

 

New Employee Packet

New Hire Forms Checklist
Loyalty Oath

Policy Acknowledgement Statement

Employee Information Sheet
I-9 Employment Eligibility Form
W-4 Federal Withholding Allowance (Rev. 2017)

G-4 State Withholding Allowance (Rev. 7/2014)
Direct Deposit

GSEPS Handbook
GSEPS 401K Enrollment Information
GSEPS Auto-Enrollment Acknowledgement Form
GDCP New Hire Letter (hourly new hires only)
JRS Membership Application (district attorneys only)

Designation of Outstanding Wages
Selective Service Verification (Male applicants between the ages of 18-26)

Drug Custody Form (see your office manager)
Workers' Compensation Acknowledgement Form

Affordable Care Act Acknowledgement Statement
Affordable Care Act Model Notice
SHBP Enrollment (required if you elect health coverage)
SHBP Enrollment Portal User Guide
SHBP Enrollment Portal Quick Reference Guide
2017 Enrollee Decision Guide (Health)
2017 State Health Benefit Plan Rate Sheet
Flexible Benefits Employee Orientation Video

2017 Flexible Benefits Enrollment Booklet (Flexible Benefits)
2017 Flexible Benefits Rate Sheet
2017 Tri-Care Supplement
Flexible Benefits Enrollment (All Flexible Benefits forms, including beneficiary forms must be filled out online or call 1-877-342-7339)

Georgia United Credit Union Benefits Brochure

Georgia United Credit Union Membership Kit

Georgia United Credit Union Website
Same Sex Spouses and Employment Benefits Memo
 

Administrative Forms

Assistant District Attorney Application
Chief Assistant District Attorney Oath of Office
Chief Assistant District Attorney Appointment Order
Special Assistant District Attorney Oath of Office
Assistant District Attorney Oath of Office

Assistant District Attorney Appointment Order

Investigator Application

DA Investigator Oath of Office

DA Investigator Appointment Order

DOL Separation Notice

Employee Confidentiality Agreement
Employee Information Sheet (PDF)

Employee Information Sheet (This editable WORD file is very large)

Employment Eligibility Verification (I-9)

Mentoring Program Registration Form
Cell Phone Reimbursement Policy

 

Fiscal Forms

Food Stamp Payment Request Form
Georgia Hotel and Motel Tax Exemption

Motor Vehicle Assignment and Use Authorization
Monthly State Vehicle Reporting Form - for employees assigned a state vehicle
State Travel Reimbursement Form (2016)

State Travel Reimbursement Form (2017)

Vehicle Insurance Card (effective 7.1.14)
Vehicle Insurance Card
(effective 7.1.15)
Vehicle Insurance Card
(effective 7.1.16)
 

Training Forms

Out of State Travel Authorization
Statement of Limitation of Practice (for Part-Time Solicitors-General)

Payroll Forms

Designation of Outstanding Wages
Hourly Time Sheet (for online submission)
Payroll Deduction Authorization (Peace Officers' Annuity and Benefit Fund of GA)

Georgia United Credit Union Payroll Deduction Form

 

Peach State Reserves Deferred Compensation Forms

All Peach State Reserves Deferred Compensation Information

Retirement System Forms

ERS Handbook
ERS Application for Refund of Contributions

GDCP New Hire Letter (hourly new hires only)

GDCP Application for Refund of Contributions

JRS Handbook 2009

JRS Membership Application

JRS Change or Designation of Beneficiaries

GSEPS Handbook
GSEPS Opt In Form

GSEPS Application for Refund of Pension Contributions
 

State Health and Flexible Benefits Plan Forms

2017 Enrollee Decision Guide (Health)
2017 State Health Benefit Plan Rate Sheet
2017 Flexible Benefits Enrollment Booklet (Flexible Benefits)
2017 Flexible Benefits Rate Sheet

2017 Tricare Supplement
BeWell SHBP Biometric Screening Website

BeWell SHBP Biometric Screening Form
SHBP Enrollment or Change

SHBP Enrollment Portal User Guide
SHBP Enrollment Portal Quick Reference Guide
Flexible Benefits Enrollment (All Flexible Benefits forms, including beneficiary forms must be filled out online or call 1-877-342-7339)
Path 2 College 529 Application (Optional College Savings Plan)

Peachcare FAQ
Same Sex Spouses and Employment Benefits Memo

GaBreeze - Flexible Benefits

GaBreeze Poster
GaBreeze Quick Reference Guide

GaBreeze Memorandum

Workers' Compensation Forms

WC Bill of Rights (to be displayed in office)
WC Fraud Notice (to be displayed in office)
WC/MCO at a Glance (to be displayed in office)

WC/MCO Panel (to be displayed in office)
Supervisor Reporting Instructions
Incident Only Notice (When no immediate injury or no treatment needed beyond first aid)

Employee's Report of Injury

Witness Report of Injury

Victims' Services Forms

Victim Impact Restitution Form
DA Victim Advocate Appointment Order

SG Victim Advocate Appointment Order

Victim Impact Statement (revised 2010)

Suggested Rights Statement

JQC Referral Packet

JQC Referral Letter Template