Forms

(by category)

Important Note: Most of the forms are in Portable Document Format (PDF). The forms have fields to be filled out online using Adobe Acrobat Reader version 4.0 or later. PDF forms should then be printed using the printer icon near the upper-left corner of the form. PDF forms with data cannot be saved or e-mailed unless "Save with 7.0+" is in the description. Read the form instructions closely. Many forms require signatures and hardcopy submission.

Affiliate/Contractor/Zero Pay

Contractor Access Form

For use in hiring contractors.

Zero Pay/Volunteer Form

For use in appointing all unpaid affiliates and volunteers.

Benefits

Insurance Forms

Link to ALL PEBA Insurance Forms.

PEBA Notice of Election Form 

Insurance enrollment or changes.

Affordable Care Act Request for Review of Healthcare Coverage Eligibility

and Process

Appeal form for ACA eligibility and process.

PEBA Certificate Regarding Tobacco Use

Certification of Non-Tobacco/Tobacco Use.

SC Public Employee Benefit Authority (PEBA) Name/Address Change

PEBA Name/Address Change form. Employees can also update their addresses for Insurance purposes by going to mybenefits.sc.gov.

Health

State Health Plan (SHP)

State Health Plan Benefits Claim Form and Instructions

State Health Plan expenses claim form.

Prescription Drug Reimbursement/Coordination of Benefits Claim & Form Instructions

Express Scripts prescription drug claim form.

Prescription Drug Home Delivery Order Form

Express Scripts home delivery order form.
COBRA

PEBA COBRA Notice of Election form

For COBRA subscribers.

PEBA COBRA Rates Chart

COBRA Monthly Premiums.
Dental

PEBA State Dental Claim Form and Instructions

State Dental Plan claim form.
 Money Plu$

PEBA Notice of Election Form

See PEBA MoneyPlus information.

MoneyPlu$ Claim Form

Medical Spending Account and Dependent Care Spending Account reimbursement form.

Retirement

Retirement Forms

Link to ALL retirement forms.

Enrollment Form

For Use in ALL systems.

Beneficiary Form

For use in ALL systems, except State Optional Retirement Plan.

Beneficiary/Trustee Designation Form

For use in ALL systems, except State Optional Retirement Plan.

Election of Non-Membership

PEBA Election of Non-Membership form.

State Optional Retirement program (ORP) Active Group Life Beneficiary Form

SC ORP Active Incidental Death Benefit Beneficiary Designation.

Amount Change form for Supplemental Retirement Account

College's Annuity Amount Change form. (401K, 457, and/or 403b)

Compensation

Employee Bonus/Award Request Form

State-funded bonuses:

  • May only be given to Permanent Employees.
  • May not exceed $3,000 in one fiscal year.
  • Cannot be applied to persons making more than $100,000 in base pay per year.

Faculty/Staff Awards must comply with Board of Trustees' approved guidelines, and may be used for all employees.  

Compensatory Overtime Record

Used to track compensatory time for Exempt employees.  The College is not required to provide compensatory time or pay to Exempt employees.

Non-Exempt employees must record all hours worked on their timesheets in BANNER.

Request to Change Accrual Type

Used to transition non-exempt employees' overtime accrual from Cash to Compensatory Time, or from Compensatory Time to Cash.  HR cannot switch employees back and forth, depending on budgets, so please ensure that your budget can accomodate cash payouts before requesting the switch.

Request for Additional Pay

(aka RAP form) Used only for faculty dual employment, to include duties outside of teaching.

Request for Salary Change

Used for permanent employees only.

  • Increases are limited to 0-15% of base salary.  Final salary may not exceed the maximum of the assigned pay band.
  • Reasons for salary changes include additional duties/skills, performance, promotion, reassignment, upward reclassification, or retention. 
  • In some circumstances, a salary reduction may also be appropriate.  Please consult HR prior, if you believe this to be the case.

Request for Temporary Salary Adjustment 

Used for permanent employees only.  TSAs are short-term adjustments in rate of pay to compensate an employee for taking on additional duties within their own Department:

  • Duties should be performed during normal business hours and are similar in nature to employee's primary duties, but often of a higher level or greater volume.
  • TSAs cannot exceed more than one year, or exceed 15% of the employee's salary for the period of time.

Request for Internal Dual Employment (RIDE)

Used for permanent employees performing internal dual employment by working for a separate department (or in isolated cases, within their primary department) to perform independent additional duties that are not related to the work performed in their primary position.

Employment, Hiring, and Separation

Employment Verification Release

Used to fulfill Employment Verification Requests.

S2 Background Check Disclosure, Release, and Authorization Forms (without credit check)

Used to request Background Checks for new employees that do not require a credit check.

S2 Background Check, Disclosure, Release, and Authorization Forms (with credit check)

Used to request Background Checks for new employees, or employees with a change in their job duties, that requires a credit check.

Request for Temporary Employee Posting/Hire Authorization

Hire Authorization Form is not required for classified staff and temporary PeopleAdmin recruitments

Faculty Hire Authorization Form

Used to request authorization to fill faculty vacancies.

Adjunct Appointment

Used for new adjuncts, never before employed at the College.

Temporary Appointment (all required forms)

Used for hiring and employing individuals on a temporary basis to do non-teaching work that is not assigned to a permanent employee:

  • Appointments may not exceed 12 months, but can be renewed.  Temporary employees (part and full-time) must have a break-in-service of no less than 15 working days after one full year of employment.
  • Job Description and source of funding information is required.
  • Recruitment is not required for temporary positions.

Temporary Appointment Renewal Form

Used only for renewal of existing employees actively under temporary contract with the College.

College Telecommuting Agreement, Schedule and Checklist (all required forms) Used by supervisors to submit a request to request, describe, and document a telecommuting arrangement for an employee.  Please refer to the College's Telecommuting Policy (link) for guidelines and information.
Request For Employee Posting/Hire Authorization Attach to new temporary appointment forms, unless the position is being recruited through People Admin.

Employee Exit Checklist

Used for the College's Internal Use, when employees are leaving.  Ensures various actions have been taken by the employee and supervisor prior to end date.

Flexible Scheduling

Flexible Work Schedule Request and Guidelines

Used for requesting a compressed or alternative work schedule, or a rotating work week arrangement.  All Flexible Work Schedule requests should be initiated by supervisors, and must be reviewed and signed by Department Heads and Human Resources prior to the schedule starting.

Grievance

Staff Employee Grievance Form

 Leave

Advanced Sick Leave Request 

Advanced Sick Leave Repayment Agreement

Application for Reduced Teaching for New Faculty Parents

Certification of Health Care Provider for Employee's Serious Health Condition (FMLA-WH380E)

Certification of Health Care Provider for Family Member's Serious Health Condition (FMLA-WH380F)

Certification of Qualifying Exigency for Military Family Leave

FMLA WH-384 form.

Leave Request Form

Request for Leave Transfer

Leave Pool Transfer Program.

Leave Donation Request

Leave Pool Transfer Program.

Payroll and Tax

  • If you need a reprinted copy of your W-2 Form, please contact our Payroll Office directly.

W4 Form

Direct Deposit Form

For the protection of our employees, this form must be delivered to Human Resources in person, by the person requesting the change.  ID will be required before changes are made.

How to Complete the Form and Frequently Asked Questions

CashPay Schedule of Fees

Deferred Compensation Policy and Form

9/12 month payment election form-IRS Code 409A

Frequently Asked Questions

Form 8843 Instruction

Resident v. Non-Resident

FICA Exemption

Non-Immigrant Forms and Explanations.

Personal Data

Name/Address Change

For College purposes only - please see Benefits section for PEBA form.

Personal Data Sheet

For College purposes only - New Hire Data Sheet

Voluntary Self Identification of Veteran Status

Optional form for new employees, used to indicate veteran status.

Workers' Compensation

Employee Statement of Injury 

Mileage Reimbursement

Supervisor Statement of Injury

Witness Statement of Injury