Benefits/ Payroll Information/ Leave Forms

Ext.	Form File Name	Title & Description	User Instructions
	EXOP3-2.pdf	Overtime Compensation Agreement for  Non-Exempt Employees	Instructions
	FMLA 1-1 to 1-8	Family and Medical Leave Act Overview (FMLA) & forms	Instructions
	KSU1-11.pdf	Payment of Health Care Premiums for State of Kansas Employee Health Care Program for Non-State Groups	Instructions
	KSU1-11b.pdf	Notice of Intent to Participate in the State of Kansas Health Care Program for Non-State Groups	Instructions
	KSU1-12.pdf	Bank Draft Approval for State of Kansas Employee Health Care Program for Non-State Group	Instructions
	KSU8-25.xls	Record of Hours Worked and Leave for Office Professionals (Excel)	Instructions
	KSU8-25.pdf	Record of Hours Worked and Leave for Office Professionals (Print Only)	Instructions
	KSU8-32.pdf	Consulting Request for Use by Extension Agents	Instructions
	KSU8-42.xls	Local Unit Employee Leave Monthly Summary	Instructions
	PR-5 (2013)	Unclassified Annual and Sick Leave Record for FY 2013	Instructions
	PR-5 (2013) Excel	Unclassified Annual and Sick Leave Record for FY 2013 (Excel)	Instructions
	PR-5 (2014)	Unclassified Annual and Sick Leave Record for FY 2014	Instructions
	PR-5 (2014) Excel	Unclassified Annual and Sick Leave Record for FY 2014 (Excel)	Instructions
For Classified Annual & Sick Leave Forms visit Division of Human Resources - Forms Page (Leave Record)

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Budgets and Financial Forms

Ext.	Form File Name	Title & Description	User Instructions
	GAAP1-1 & 1-2.pdf	Generally Accepted Accounting Principles (GAAP) Waiver Resolution for Extension Councils and District Governing Bodies	Instructions
	KSU1-13.pdf	Responsibilities for Extension Council/ District Administration of Extramural Funds Form	Instructions
	KSU1-14.pdf	Electronic Funds Transfer Authorization	Instructions
	KSU1-18.pdf	Direct Deposit of Salary Authorization	Instructions
	KSU4-1 to 4-4	- Financial Review Committee Responsibilities - Financial Review Checklist - Annual Financial Report - 4-H Club Treasurer Job Description	Instructions
	KSU8-1.pdf	Budget for County Extension Council	Instructions
	KSU8-2.pdf	Certificate of Filing County Extension Budget	Instructions
	KSU8-3.pdf	Certificate of Appropriation - Print Only	Instructions
	KSU8-10.pdf	County Equipment Inventory	Instructions
	KSU8-10.xls	County Equipment Inventory (Excel)	Instructions
	KSU8-10.wb3	County Equipment Inventory (Quattro Pro)	Instructions
	KSU8-17.pdf	Travel Payment Voucher	Instructions
	KSU8-19.xls	Financial Check Sheet with Budget Development and Management Worksheets (Excel)	Instructions
	KSU8-34.pdf	Transfer of Property and Funds (From County Extension Councils to Extension Districts)	Instructions
	KSU8-35.pdf	Invoice	Instructions
	KSU8-36.pdf	Vehicle Daily Log	Instructions
	KSU8-37.xls	Salary Proposal Worksheet	Instructions
	KSU8-39.xls	Extension Council/District Staff Salary and Benefits Record	Instructions
	KSU8-41.xls	Program/Service Costs Calculation Worksheets (On-Campus and Off-Campus)	Instructions
	KSU9-10.pdf	District Equipment Inventory	Instructions
	KSU9-10.xls	District Equipment Inventory (Excel)	Instructions
	KSU9-10.wb3	District Equipment Inventory (Quattro Pro)	Instructions
	KSU9-19.xls	District Financial Check Sheet with Budget & Development & Management Worksheets (Excel)	Instructions

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Civil Rights Forms

Ext.	Form File Name	Title & Description	User Instructions
	CR-1	Annual Civil Rights Mini-Review
	CR-2	Civil Rights Program Compliance Review Guide 2010-2013

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Crisis Management Forms

Ext.	Form File Name	Title & Description	User Instructions
	KSU8-33.pdf	Crisis Management Planning	Instructions
	KSU8-33a.pdf	Crisis Management Planning - Pocket Form	Instructions

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Employment Forms

Ext.	Form File Name	Title & Description	User Instructions
	Conflict of Interest	Declaration of Conflict of Interest and Time Commitment Forms - KSU	Instructions
	EXOP3-5	Approval to Employ an Extension Program Assistant	Instructions
	EXOP3-7	Applicant Information Profile Office Professionals and Program Assistants	Instructions
	EXOP3-9	Screening of Office Professional and Program Assistant Applicants Prior to Interview (Print Only)	Instructions
	EXOP3-11	Employment Agreement Office Professionals and Program Assistants	Instructions
	EXOP3-13	Employee Performance Review Office Professionals and Program Assistants	Instructions
	EXOP3-15	Personnel Action Form (For Area Office Use Only)	Instructions
	EXOP3-16	Extension Agent Exit Interview	Instructions
	EXOP3-17	Employee Separation Checklist for Local Unit	Instructions
	EXOP3-18	Exit Interview Office Professional and Program Assistant	Instructions
	KSU1-2.pdf	Extension Agent Employment Agreement	Instructions
	KSU1-16.pdf	Area Specialist Performance Appraisal Input Form	Instructions
	KSU1-17.xls	Recruiting/Offer Form	Instructions
	KSU8-29OP	Office Professional - Application for Employment - Print Only	Instructions
	KSU8-29PA	Program Assistant - Application for Employment - Print Only	Instructions
	KSU8-29OP.pdf	Office Professional - Application for Employment (This form can be filled in and printed)	Instructions
	KSU8-29PA.pdf	Program Assistant - Application for Employment (This form can be filled in and printed)	Instructions
	Link to Login	Annual Extension Agent Performance Review Electronic Version
	KSU8-30a.pdf	Annual Extension Agent Performance Review	Instructions
	KSU8-30b.pdf	Annual Extension Agent Performance Review:  Summary	Instructions
	KSU8-30c.pdf	Annual Extension Agent Performance Review:  External Feedback	Instructions

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Extension Council and Governing Body Forms

Ext.	Form File Name	Title & Description	User Instructions
	KSU8-38.pdf	Template for Extension Board Meeting Minutes	Instructions
	KSU8-40.pdf	Excellence in Board Leadership Board Assessment
	PM1	Handbook for County Extension Councils and District Governing Bodies	Instructions
	Council Forms
	KSU8-4a.pdf	Extension Council Executive Board Members and County Extension Council Members elected by Commissioner Districts	Instructions
	KSU8-4b.pdf	Extension Council Executive Board and County Extension Council Members elected At Large	Instructions
	KSU8-4a&b.xls	Extension Council Executive Board Members and County Extension Council Members (Excel)	Instructions
	KSU8-10.pdf	County Equipment Inventory	Instructions
	KSU8-10.xls	County Equipment Inventory (Excel)	Instructions
	KSU8-10.wb3	County Equipment Inventory (Quattro Pro)	Instructions
	KSU8-15.pdf	Extension Council Member Record	Instructions
	KSU8-15.xls	Extension Council Member Record - Excel	Instructions
	KSU8-20.pdf	Oath to support U.S. and Kansas Constitution, County Version	Instructions
	KSU8-23.pdf	Public Notice of Annual Meeting of County Extension Council	Instructions
	KSU8-24a.pdf	Public Notice of Extension Council Election at Large	Instructions
	KSU8-24.pdf	Public Notice of Extension Council Elections at Three Locations	Instructions
	District Forms
	KSU8-34.pdf	Transfer of Property and Funds (From County Extension Councils to Extension Districts)	Instructions
	KSU 9-4.xls	Governing Board of the Extension District (Excel)	Instructions
	KSU9-4.pdf	Governing Board of the Extension District	Instructions
	KSU9-5.pdf	District Operational Agreement	Instructions
	KSU9-6.pdf	District Office Space Agreement	Instructions
	KSU9-10.pdf	District Equipment Inventory	Instructions
	KSU9-10.xls	District Equipment Inventory (Excel)	Instructions
	KSU9-10.wb3	District Equipment Inventory (Quattro Pro)	Instructions
	KSU9-15.pdf	Governing Body Member Record	Instructions
	KSU9-15.xls	Governing Body Member Record - Excel	Instructions
	KSU9-20.pdf	Oath to support U.S. and Kansas Constitution, District Version	Instructions

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Master Farmer - Master Farm Homemaker Forms

Ext.	Form File Name	Title & Description	User Instructions
	KSU1-10.pdf	Kansas Master Farmer-Master Homemaker Workbook	Instructions

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Sabbatical and Study Leave Application Forms

Ext.	Form File Name	Title & Description	User Instructions
	Application	Application for Sabbatical Leave from Kansas State University
	Guidelines	Guidelines for Sabbatical Leave from Kansas State University
	KSU1-9c.pdf	Application for Study Leave other than Sabbatical Leave	Instructions

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For Information on Portable Document Format (pdf) files visit www.ksu.edu/tools/pdf webpage.

If you do not have the Adobe Acrobat Reader, you may get the free download from the Adobe web site .