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Human Resources
Division of Administration
  2. Forms
  3. Tools and Forms

Tools and Forms

All forms are viewable using Adobe Acrobat (.pdf), unless otherwise noted.

Use the search box below to look for the form you need or use the column headers to sort the forms alphabetically or by form type.



Form Name Form Type
415c Aggregation Form Benefits
Adoption & Surrogacy Assistance Reimbursement Request Form Benefits
Aetna Claim Form (for domestic and international claims) Benefits
Benefit Appeal Request Benefits
BlueCross BlueShield DentalBlue PPO - Claim Form Benefits
Criminal Background Disclosure Process Employment
Dependent Information Change Form Benefits

Direct Deposit Enrollment and Updates

 Payroll
Employment Law Posters Employment
Exit Interview Questionnaire Employment
Family and Medical Leave Act (FMLA) FMLA
Family Status Change Request Benefits

Flexible Spending Account (FSA) form 


For more information on how to submit an FSA Claim Form click here. 

 Benefits
Long-Term Disability Certification of Prior Coverage Form Benefits
Medicare Creditable Coverage Notice Benefits
MetLife Statement of Health Form Benefits
Navitus Compound Claim Form Benefits 
Navitus Drug Claim Form Benefits
Navitus Foreign Claim Form (for prescriptions purchased outside the United States) Benefits
Notice of Privacy Practices Benefits
Notification of Family Status Change Benefits
Notice of Employee Working Outside of Tennessee Employment
Superior Vision Claim Form Benefits
Employment Eligibility Verification (I-9) Employment
Employee Information Forms: Employment
Off-Cycle Payroll Request Form Payroll
Paycard Application Form Employment
Performance Evaluation Employment
Performance Evaluation (Leadership Model) Employment
Position Description Questionnaire (PDQ) Employment
End of Employment Process Checklist Employment
How To Read Your W-2
W-2 Calculator 		Employment
Federal Tax Forms:

Form 1095-C information

State Tax Forms:

  1. Alabama A-4 Form (Alabama State Tax Withholding Allowance)
  2. Arizona A-4 Form (Arizona State Tax Withholding Allowance)
  3. California DE-4 Form (California State Tax Withholding Allowance)
  4. Colorado W-4
  5. Connecticut CT-W-4 (Connecticut Tax Withholding Allowance)
  6. Georgia G-4 Form (Georgia State Tax Withholding Allowance)
  7. Illinois IL-W4 (Illinois Tax Withholding Allowance)
  8. Indiana IN-WH4 (Indiana Employee's Withholding Exemption)
  9. Iowa IA-W4 (Iowa W-4)
  10. Kentucky K-4 Form (Kentucky State Tax Withholding Allowance)
  11. Kentucky K-4E form (Kentucky State Tax Withholding Allowance) For Exemption
  12. Louisiana L-4 (Louisiana Tax Withholding Allowance)
  13. Louisiana L-4E (Louisiana Exemption from Withholding Louisiana Income Tax)
  14. Maryland MW-507 Form (Maryland State Tax Withholding Allowance)
  15. Massachusetts M-4 (Massachusetts Tax Withholding Allowance)
  16. Minnesota W-4
  17. Mississippi Employee's Withholding Exemption Certificate
  18. Nebraska W-4
  19. New Jersey W4 Form (New Jersey State Tax Withholding Allowance)
  20. New Mexico W-4
  21. New York IT-2104 E (New York Non-withholding Form)
  22. New York IT-2104 (New York Tax Withholding Allowance)
  23. North Carolina NC-4 (North Carolina Tax Withholding Allowance)
  24. Ohio IT-4 Form (Ohio State Tax Withholding Allowance)
  25. Oklahoma W-4
  26. Oregon W-4
  27. Pennsylvania REV-419 AS (Pennsylvania Non-Withholding Form)
  28. Rhode Island W-4 (Rhode Island Tax Withholding Allowance)
  29. South Carolina W-4
  30. Utah W-4
  31. Vermont W-4
  32. Virginia-4 Form (Virginia State Tax Withholding Allowance)
  33. Washington D.C. D-4 Form (Washington D.C. Tax Withholding Allowance)
 Employment
Non-FMLA Medical Leave FMLA
Alternative Work Arrangement Request Employment

Check Replacement Request Form 

 Payroll

Waiver of No-Hire Provision

Employment