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Utah Department of Human Resource Management Forms

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Form STGT-2 Group Term Life Spouse/Dependent Child Enrollment Form - Utah PDF

Form STGT-2 Group Term Life Spouse/Dependent Child Enrollment Form - Utah
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Form HSA0 Hsa Benefit Card Agreement Limited FSA Enrollment Form - Utah PDF

Form HSA0 Hsa Benefit Card Agreement Limited FSA Enrollment Form - Utah
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Form FI40B Private Vehicle Usage Report for Reimbursement at .56 Per Mile - Utah, 2021 PDF

Form FI40B Private Vehicle Usage Report for Reimbursement at .56 Per Mile - Utah, 2021
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Form GTL-C Group Term Life Change Form - Utah PDF

Form GTL-C Group Term Life Change Form - Utah
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Form SI7533D-646597 Short Term Disability Enrollment and Change Form - Utah PDF

Form SI7533D-646597 Short Term Disability Enrollment and Change Form - Utah
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Career Service Exempt Appointment Acknowledgment - Utah PDF

Career Service Exempt Appointment Acknowledgment - Utah
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Career Service Exempt Conversion Notice and Election Form - Utah PDF

Career Service Exempt Conversion Notice and Election Form - Utah
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Employee Termination Exit Interview - Utah PDF

Employee Termination Exit Interview - Utah
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Employee Termination Checklist - Utah PDF

Employee Termination Checklist - Utah
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Overtime Compensation Election/Agreement for Flsa Non Exempt Employees - Utah PDF

Overtime Compensation Election/Agreement for Flsa Non Exempt Employees - Utah
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Overtime Compensation Election/Agreement - Utah PDF

Overtime Compensation Election/Agreement - Utah
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Group Term Life Employee Enrollment Form - Utah PDF

Group Term Life Employee Enrollment Form - Utah
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Pehp Flex$ Salary Reduction Agreement - Utah PDF

Pehp Flex$ Salary Reduction Agreement - Utah
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Medical ACA Enrollment Form - Utah PDF

Medical ACA Enrollment Form - Utah
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Enrollment and Change Form - Utah PDF

Enrollment and Change Form - Utah
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Career Service Exempt Appointments (Schedule AB, Ac, Ad, Ar, as, AE, & at Employees) - Utah PDF

Career Service Exempt Appointments (Schedule AB, Ac, Ad, Ar, as, AE, & at Employees) - Utah
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Internal User Hre Security Access Request Form - Utah PDF

Internal User Hre Security Access Request Form - Utah
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Application for Family and Medical Leave - Utah PDF

Application for Family and Medical Leave - Utah
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Uncompensated Overtime Claim Form - Utah PDF

Uncompensated Overtime Claim Form - Utah
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Authorization to Make Unused Program I (Pre-2006) Sick and Converted Sick, and/or Program II (Pre-2014) Sick Available for Paid Absences - Utah PDF

Authorization to Make Unused Program I (Pre-2006) Sick and Converted Sick, and/or Program II (Pre-2014) Sick Available for Paid Absences - Utah
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One-Time and Irrevocable Authorization to Transfer All Program I (Pre-2006) Sick and Converted Sick Leave Hours to Program II (Pre-2014) Sick and Converted Sick - Utah PDF

One-Time and Irrevocable Authorization to Transfer All Program I (Pre-2006) Sick and Converted Sick Leave Hours to Program II (Pre-2014) Sick and Converted Sick - Utah
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Exempt Employee Group Term Life Enrollment Form - Utah PDF

Exempt Employee Group Term Life Enrollment Form - Utah
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Overtime Compensation Election/Agreement Form - Utah PDF

Overtime Compensation Election/Agreement Form - Utah
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Personal Information Form - Utah PDF

Personal Information Form - Utah
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Pehp Leave Worksheet - Utah PDF

Pehp Leave Worksheet - Utah
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Conflict of Interest Clearance Form - Utah PDF

Conflict of Interest Clearance Form - Utah
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Request for Payment of Leave Balances for Employees Approved for Long Term Disability - Utah PDF

Request for Payment of Leave Balances for Employees Approved for Long Term Disability - Utah
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Reference Release Form - Utah PDF

Reference Release Form - Utah
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Employment Reference Check Form - Utah PDF

Employment Reference Check Form - Utah
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Termination Checklist & Exit Interview Form - Utah PDF

Termination Checklist & Exit Interview Form - Utah
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Voluntary Termination Form - Utah PDF

Voluntary Termination Form - Utah
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Blank Coded BI-Weekly Time Sheet - Utah PDF

Blank Coded BI-Weekly Time Sheet - Utah
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BI-Weekly Time Sheet - Utah PDF

BI-Weekly Time Sheet - Utah
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Military Leave Worksheet - Utah PDF

Military Leave Worksheet - Utah
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Acceptance of Duties Under the Medical Cannabis Act Acknowledgement Form - Utah PDF

Acceptance of Duties Under the Medical Cannabis Act Acknowledgement Form - Utah
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Conditional Job Offer - Acceptance of Duties Under the Medical Cannabis Act Acknowledgement Form - Utah PDF

Conditional Job Offer - Acceptance of Duties Under the Medical Cannabis Act Acknowledgement Form - Utah
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Abusive Conduct Intake Form - Utah PDF

Abusive Conduct Intake Form - Utah
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In-state Work Location Policy Request for Exception to Work and/or Take Equipment out of the Country - Utah PDF

In-state Work Location Policy Request for Exception to Work and/or Take Equipment out of the Country - Utah
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