Kansas Adjutant General's Department
Forms

FORMS and DOCUMENTS

Payroll or Time Recording Forms and Documents

 

Security Clearance Forms

Direct Deposit Form
Flex-Time Request Form
K-4 Kansas Withholding Form
Overtime Request Form
Standby Log
Time Recording Codes
Paper Time Sheet
W-4 Federal Withholding Form
Leave Benefits Outline

 

State Application Form
OF 306
Request for Security Clearance
Request for Investigation of Suitability
Fingerprint Locations
KDHE-How to obtain a copy of your BIrth Certificate
SF-312
Security Clearance Acknowledgement Form
Security Clearance Policy
S
ecurity Authorization Access Request (SAAR)
 

Workers Compensation Forms

   

Employer's Report of Accident (K-WC 1101-A) 
Injured Employee's Report of Injury (WC-9)

Information for Injured Employees (K-WC 27-A)
Workers Compensation Rights and Responsibilities (K-WC 40-A)

 

Workers' Compensation First Fill Prescription Form
Replacement of Prescription Eyeglasses (WC-00)
Guidelines for Repair or Replacement of Eyeglasses (WC-00-A)
Mileage Reimbursement

 

Miscellaneous Forms

 

Family Medical Leave Act Forms & Documents

Affidavite of Common Law Marriage
Employee Data Sheet (Change of phone or Address)
Resignation Form
Self Service Login Information
Separation Checklist
Grievance Forms
Performance Review with  Instructions
Performance Review PDF Fillable (Form must be downloaded to use)
Supervisor Exit Form
State Health Plan Change Form
Job Hazard Analysis Form
Green Sheet - SHRO Transaction Request Form
DD2875 System Authorization Access Request
AUP IT Policy letter
ATCTS Registration
IA Awareness training
S
ubmitting a New Domain process
 

 

FMLA Medical Certification for Employee's Health Issues
FMLA Medical Certification for Family Member's Health Issues
FMLA for Injured Covered Service Member
FMLA for Qualified Exigency for Military

Employee FMLA Guide
Supervisors FMLA Guide

Shared Leave application

CONTACT US:     E-Mail

HR Director - (785) 646-1460

Payroll/Benefits - (785) 646-1391

FAX - (785) 646-1679

 

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QUICK LINKS
 

Emergency Information

Click here for emergency preparedness information, safety awareness information and general information about severe weather and other potential emergencies that Kansans should be prepared for.

For information provided by Kansas Division of Emergency Management, click here.

For information provided by Kansas Homeland Security, click here.

 

Copyright © 2017, KANSAS ADJUTANT GENERAL'S DEPARTMENT
Questions/suggestions to: Public Affairs Director