HR Forms
Benefits and Well-Being
Insurance - General Forms
- Active Employee Notice of Election
- Retiree Notice of Election
- COBRA Notice of Election
- Certification Regarding Tobacco Use
- IRS Form 1095-C
Health Insurance Claims
- Health Expenses Claim Form
- BlueCard Worldwide Claim Form (for services outside the U.S.)
Prescription Coverage Claims
Dental Insurance Claims
Vision Claims
- Out of Network Vision Services Claim Form
- Medically Necessary Contact Lens Claim Form
- Medically Necessary Contact Lens Claim Form – Out-of-Network
Tax-Free Savings Accounts
- MoneyPlus Enrollment Form (MSA & DCSA Enrollment and HSA Enrollment/Change)
- MoneyPlus Claim Form 2018 (Medical Spending and Dependent Care)
- MoneyPlus Claim Form (2019)
- MoneyPlus Worksheet (Determining Annual Contribution Amount)
- Active Notice of Election Form
Life Insurance
Long-Term Disability Insurance
- Medical History Statement (Request for Enrollment)
- Conversion Request (Due to Separation from Employment)
Family Medical Leave Act (FMLA)
Special Leave Requests
- Request an Extended Leave of Absence Form and Instructions
- Request Annual Leave Over 30-Day Maximum Form and Instructions
- Leave Pool Request Form and Instructions
- Leave Pool Donation Secured Web Link
- Sabbatical Leave Request Form
Retirement - General Forms
- Enrollment Form (All Systems)
- Election of Non-Membership
Beneficiary Designations
- SCRS/PORS - Beneficiary of Account and Incidental Death Benefit
- ORP – Beneficiary of Incidental Death Benefit
- Retired Member Change of Beneficiary
Account Refund
- SCRS/PORS Account Refund Request (Due to Separation from Employment)
Service Purchase (For SCRS/PORS Members)
- Request for Service Purchase
- Service Purchase Salary Verification
- Public/Education Service Verification
- State ORP Service Verification
Retiring from Clemson
Classification & Compensation
- Personnel Action Request
- Bonus & Award Form
- Bonus & Award Form-Multiple Listing
- Establish a New Award
- Life Sciences Act Bonus Submission Form
- Multiple Bonus Payment Spreadsheet
- Multiple Performance Increase Spreadsheet
- Salary Increase Request for Student Employees
- Salary Reduction Form
- Position Description Form
- Quick Reference Writing a PD
- Dual Employment Request Form
- Dual Employment Revised Schedule Request
- Multiple Dual Employment List
Data Center & Records
- Change of Address Links
- I - 9 Form
- FUND 20 Project Guide to Forms
- Change Hire Form
- Non-Paid Worker Hire Worksheet
- Data Entry Change Form (Changes Not Requiring Approvals)
- Earnings Distribution Form
- Employment Hire Form
- Multiple Earnings Distribution Form
- Multiple Supervisor Change Form
- New Employee Data Sheet
- Quick Glance Form Guide
- Completing an I-9 Form Quick Reference
Staff and Faculty Relations
Employment Action Request Package
- Employment Action Request
- Employment Action Request Additional Sheet
- Employment Action Justification Additional Sheet
- For best user experience, you should download the PDF form locally and then fill out the form.
International Employment
- Employment Verification Letter for F-1 Visa
- Employment Verification Letter for J-1 Visa
- International Employment Forms Packet
- Social Security Card Application
Payroll
- Closed Bank Account - Reissue Paycheck Form
- Employee Working Outside South Carolina Form
- Timesheet Instructions
- Employee Time Sheet 2019 (Excel)
- Employee Time Sheet 2019 (Handwritten)
- Kronos Additional Access Request
- Lost Check - Reissue Paycheck Form
- Request for Off-Cycle Payroll Process
- SC State Credit Union Form
- Special Pay
- Travel
- W-2 Request Form
- W-4 Link and Instructions
- Faculty 9 month pay over 12 months (Available Annually in August)
- Overpayment process: call Payroll at 864-656-5580
Recruitment
Release of Information (CDL, Safety Sensitive, High Risk / Security Sensitive)