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Forms
For forms labeled "PDF", the free Adobe Acrobat Reader software is required to view and in some cases fill them out. Forms in other formats (MS Word, MS Excel, etc) are indicated where appropriate.
To open a form once you have chosen it, click on the linked file type (such as pdf or doc).
For questions about individual forms, please contact this agency's forms coordinator, Allen Aitken at 317-232-3074.
If you do not see a form in the list below, please login at Forms.IN.gov to search. To login, enter your user name, password and domain that you use to log in to the state network.
State Personnel Department Forms Catalog
| Title and State Form Number | Download as... |
|---|---|
| Acknowledgement of Agency Policies and Procedures - 54116 | |
| Acknowledgement of Standardized Policies and Employee Handbook - 54115 | |
| Applicant Background Record Checklist - 53390 | pdf | doc |
| Applicant Disclosure and Release for Consumer and Investigative Consumer Reports - 51334 | pdf | doc |
| Attending Physician's Statement - 45547 | doc |
| Civil Service Complaint Form - 54707 | |
| Emergency Family and Medical Leave (EFML) Request Form - 56940 | pdf | doc |
| Emergency Paid Sick Leave (EPSL) Request Form - 56941 | pdf | doc |
| Emergency Paid Sick Leave (EPSL) Request Form for Emergency Responders and Health Care Providers - 56942 | pdf | doc |
| Employee Attendance Report (A-4) - 14304 | pdf | xls |
| Employee Compensatory Time Worksheet - 42386 | |
| Employee's Authorization for Release of Medical Information - 50107 | pdf | doc |
| Employee's Claim Statement - 45544 | doc |
| Employee Work Profile and Performance Appraisal Report - 52403 | pdf | doc |
| Employer's Report of Claim - 45548 | doc |
| Evaluation of Training - 45910 | doc |
| Indiana State Employee Suggestion Program Submission - 922 | |
| Instructions for Submission of a Disability Claim - 50106 | pdf | doc |
| Interim Performance Appraisal -52404 | pdf | doc |
| Job Analysis Questionnaire (PAT, COMOT, LTC, POLE, & SAM Categories) - 43434 | doc |
| Job Description - 52468 | pdf | doc |
| Classified Working Test Appraisal - 53740 | pdf | doc |
| New Hire Nurse Worksheet - 53516 | |
| New Hire Teacher Worksheet - 56919 | |
| Options Statement - 50108 | pdf | doc |
| Position Data Change Worksheet - 53665 | |
| State Employee Community Service Program Request for Leave and Verification of Services Provided - 49044 | |
| Verification of Dependent Disability - 53388 | |
| Waiver of Privilege to Have Coworker Witness Present at Pre-Deprivation Meeting- 54118 | |
| Work Improvement Plan - 52405 | pdf | doc |
| Written Counseling - 54117 | |
| Written Reprimand - 54119 |
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