To select a form, simply double-click on your selection. All the forms will be downloaded in Adobe Acrobat format. You will need an Adobe Acrobat reader to view or print the forms. You can download the reader for free from the Adobe Web Site at http://www.adobe.com/
Note: If you have trouble reading the form in your web browser after clicking, try right clicking the link, then save the form to your desktop. From there, left click to open it up within the Acrobat Reader program.
You should have Adobe 7.0 and higher for these forms to download. There is also a backup of these forms saved on the P drive under “HR Forms.”
Please submit 2 copies of each form you complete. Retain a 3rd copy for your records.
ETRAC - Transportation
Flexible Spending Accounts (FSAs)
FSA -Address Change Form
FSA- Reimbursement Claim Form - To request reimbursement of eligible purchases that were not purchased with a Beniversal card.
FSA - Direct Deposit Reimbursement Authorization - To Authorize claim reimbursements to be directly deposited into your bank account.
FSA- Certification of Medical Necessity - For services/items that require additional documentation from a licensed health care provider (submit with your claim form)
FSA - Statement of Dependent Care Expenses
TIAA -CREF - Retirement Annuity
To open your own Retirement Annuity and/or Group Supplemental Annuity account please follow the following steps (also see FAQs):
- Log into Ceridian Self-Service - https://sourceselfservice2.ceridian.com/marymount, and make your desired allocations under the 401k/403b elections. This ensures that money will be taken out of your paycheck.
- Visit www.tiaa-cref.org/mmm to on a contract with Tiaa-Cref and make your fund allocations
Performance Evaluation Procedures
Performance Evaluation Form Professional Staff (PDF)
Performance Evaluation Form Profession Staff (Word Doc)
Performance Evaluation Form Administrative Staff (PDF)
Performance Evaluation Form Administrative Staff (Word Doc)
WAGE THEFT PREVENTION
Complete a Departmental Accident Report and meet with a H.R. representative within 7 business days (injury permitting) in order to ensure that your workers compensation claim will be processed.
TUITION REIMBURSEMENT & REMISSION
WH-380-E Certification of Health Care Provider for Employee’s Serious Health Condition
WH-380-F Certification of Health Care Provider for Family Member’s Serious Health Condition
WH-381 Notice of Eligibility and Rights & Responsibilities
WH-382 Designation Notice
WH-384 Certification of Qualifying Exigency For Military Family Leave
WH-385 Certification for Serious Injury or Illness of Covered Service member — for Military Family Leave
WH-385-V Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave