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Conflict of Interest Form

DHRM Rules R477-9-2 and R477-9-3 require that employment with the state be the principal vocation for full-time employees. A state employee may only engage in outside employment or receive honoraria or paid expenses for activities outside of state employment when the employment or activities do not: a. Interfere with the employee’s efficient job performance. b. Conflict with the interests of the agency or the State of Utah. c. Give reason for criticism or suspicion of conflicting interests or duties. An employee must notify agency management in writing if outside employment or paid ...

Military Leave Worksheet

This form is for employees who will be out on Military Leave (after 15 days of Military Leave has been exhausted).  The form allows the employee to select options for payment of premiums during military leave and designates how much personal leave the employee would like to use. Military Leave Form (Excel) Military Leave Form (PDF)

Blank Time Sheet

This is a blank time sheet to report hours if you are not able to complete time entry is ESS.  This form must be completed and submitted to the payroll contact for your agency or to ERIC payroll via the AskHR tool or via email to ericpayroll@utah.gov. blank timesheet  

Blank Time Sheet for Finet Coding

This is a blank time sheet to report hours coded to different projects or work sites if you are not able to complete time entry is ESS.  This form must be completed and submitted to the payroll contact for your agency or to ERIC payroll via the AskHR tool or via email to ericpayroll@utah.gov. blank coded timesheet

DEQ Blank Time Sheet (DEQ Employees Only)

Use this form if you are an employee of Department of Environmental Quality only. DEQ ONLY Timesheet Excel

URS Statement of Ineligibility

This form notifies URS when an employee is not eligible for retirement benefits and also notifies the employee they can contribute on their own to a 401k account if they choose to do so.  This certification is normally part of the Onboarding process completed by the Employee Resource Information Center. URS Statement of Ineligibility 1/2014

URS Leave Notification Form

This form notifies URS when an employee is out on Leave Without Pay status so retirement benefits can be adjusted as necessary. URS Leave Notification

URS Eligibility Certification Form

This form notifies Utah Retirement Systems an employee is eligible for retirement benefits.  An authorized signature is required and this process is normally part of the Onboarding process of a new state employee. URS Eligiblity Certification Form

URS 457 Withdrawal/Rollover Form

Complete this form to rollover eligible funds to your URS 457 account or to withdraw funds upon leaving state employment. 2015 URS 457 Withdrawl/Rollover Form

URS 401k Withdrawal/Rollover Form

Complete this form to either rollover funds from a previous employer or to withdraw funds from your URS 401(k) account if you are leaving state employment.  2015 URS 401(k) Withdrawal/Rollover Form

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