Kansas Adjutant General's Department


Payroll or Time Recording Forms and Documents


Security Clearance Forms

Flex-Time Request Form
K-4 Kansas Withholding Form
Overtime Request Form
Leave 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
Security Clearance Acknowledgement Form
Security Clearance Policy
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

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
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) 646-2266

Payroll/Benefits - (785) 646-2261

Recruiting - (785) 646-2263

FAX - (785) 646-0565


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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.


Questions/suggestions to: Public Affairs Director