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Forms
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The forms below are in Adobe Acrobat format (.pdf) for the ease of downloading and printing. Please fax or mail forms to your Human Resources representative. Contact your Human Resources representative for more information and questions.

* Denotes interactive form

Contact HR Staff

Personnel
AOC Supporting Document Form (SDF) (Word)
Application for Educational Leave Form (PDF)
Application for Educational Leave Form (Word)
Application for Educational Leave Form (WordPerfect)
Certified Bilingual Compensation Request Form 10 24 11
Certified Bilingual Training Reimbursement Request Form 10 24 11
Degrees of Family Relations 9 11
Disciplinary Action Form
Drug & Alcohol Prevention and Testing Mandatory Acknowledgement Form
Drug-Free & Alcohol-Free Work Place Policy
Employee Physical Fitness Contract
Employment Reference Form
Grievance Form *
I-9 Form Employment Eligibility Verification
Outside Employment Form Rev. 10 6 11
Personal Data Form (Word)
Security Incident Report Form
Security Incident Supreme Court Order
Telephone Threat Form
Volunteer Agreement Form


Job Applications
Job Application Form (Rev. 5 18 10) PDF
Job Application Form (Rev. 5 18 10) WORD
Resume Supplemental Form (Rev. 5 18 10) WORD


Language Access
Certified Bilingual Compensation Request Form 11.2012
Certified Bilingual Training Reimbursement Request Form 11.2012
Court Interpreter Program
Language Access Services
Language Access Specialist Program Overview 5.2013
Language Access Specialist Program Polices and Procedures 5.2013
Language Access Training Acknowledgement Form Interactive
Language Access Training Policy 10 24 11
LAS Scholarship Application


Payroll
10 Day Waiver Form Letter Rev. 4 13 10
2015 Employee Calendar
2016 Amended Holiday Schedule
2016 Employee Calendar
Administrative Leave Request Form
Affidavit for Duplicate Warrant
Direct Deposit/Automatic Payroll Deduction Form (New DFA Payment Disposition Form 9-06)
Donation of Annual Leave Form
Judicial Branch Timesheet
Request for Leave Without Pay Form
Request for Manual Payroll Warrant
Sick Leave Buyback Conversion Form Rev. 4 13 10
Terminal Leave Instructions
Terminal Leave Request Form - Interactive
Timesheet Correction Form
W-4 2016
Withholding Tax Rates, New Mexico, 2014
Withholding Tax Rates, New Mexico, History


Benefits


Benefits Worth Form
Overview of Benefits Form

Domestic Partners
Affidavit of Domestic Partnership 2012

Enrollment
Employee Benefits Instructions Handout
FMLA Certification of Health Care Provider for Employee's Serious Health Condition
FMLA Certification of Health Care Provider for Employee's Serious Health Condition - Spanish
FMLA Certification of Health Care Provider for Family Member's Serious Health Condition
FMLA Certification of Health Care Provider for Family Member's Serious Health Condition - Spanish
FMLA Certification of Qualifying Exigency For Military Family Leave
FMLA Certification of Serious Injury or Illness of a Current Servicemember - for Military Family Leave
FMLA Certification of Serious Injury or Illness of a Verteran for Military Caregiver Leave
FMLA Designation Form with Admin Authority Signature Line
FMLA Notice of Eligibility and Rights & Responsibilities
FMLA Poster - Employee Rights & Responsibilities
FMLA Request Form
State Employees Charities Campaign

Minnesota Life Insurance
Beneficiary Designation/Change Request Form
Beneficiary Statement Claim Form
Beneficiary Statement Claim Form (Minor)
Continuation of Group Life Insurance
Evidence of Insurability Request
Notice of Accelerated Claim Benefit Form (with eclaim)
Notice of Accelerated Claim Benefit Form (with no eclaim)
Notice of Death Form
Porting and Converting Group Coverage
Supplemental Life Calculator

Privacy Practices
NOTICE OF PRIVACY PRACTICES (HIPAA)
Notice of Rights to Continue Coverage

Rates
2017 Insurance Rates, 07/01/2016 - 06/30/2017
COBRA Rates July 2014 to June 2015
RMD Self Pay Permium FORM
RMD Self Pay Premium FML Explanation
Supplemental Life and ADD Rates 2011-2015


Compensation Forms

Emergency Retention Pay Action form
Temporary Salary Increase form


Out-of-Cycle Salary Increase
Out of Cycle Increase Request Form (rev April 2007) (Wordperfect)


Performance Evaluation
Employee Performance Communication Form (Eff 7 1 08/Revised 2 5 09 WordPerfect)
Employee Performance Communication Form (Eff. 7 1 08/Rev 2 20 09) WORD
Employee Performance Plan and Performance Evaluation Form (Eff 7 1 08/Rev 1 25 10) WORD
Employee Performance Plan and Performance Evaluation Form (Rev 1 25 10) WordPerfect
Performance Planning & Evaluation Manual (Rev 1 25 10)


Reclassification
AOC Supporting Document Form (SDF) (Word)
Job Analysis Questionnaire (Word)
Job Audit Memorandum 6 2 10
Job Audit Questionnaire 6 2 10
Ranked Task List (2007)


Recruitment
HR Tracking Sheet (Rev 2 23 09) PDF
HR Tracking Sheet (Rev 2 23 09) WordPerfect
Job Application Form (Rev. 5 18 10) PDF
Job Application Form (Rev. 5 18 10) WORD
New Hire Package (Rev. 12 17 2013) PDF
New Hire Package (Rev. 12 17 2013) Word
Resume Supplemental Form (Rev. 5 18 10) PDF
Resume Supplemental Form 5 18 10


Retirement
2011 Judges Handbook
PERA IRS New Reg for Normal Retirement Age Eff. 1 1 10
PERA Application for Membership 2011
PERA Application for Re-Employed Retiree 7 1 10
PERA Beneficiary Designation Form
PERA Change in Records 2011
PERA Direct Deposit Form
PERA New Hires on or after July 1, 2010 Plan Change
PERA Part-time Service Credit Rule (eff. July 2014)
PERA Spousal Consent Form - Judicial/Magistrate Retirement
PERA Termination Notice
Tier 1 Membership Handbook
Tier 2 Membership Handbook
Retiree Health Care Authority
PERA

Workers' Compensation
Authorization to Release Medical Information Form
Benefits Explanation Form
Claim Explanation Form
Doctor Visit/Modified Work Assignment Form
How to Access the Online Employers First Report of Injury or Illness Form
Notice of Accident Form (Contact HR Office)

Harassment, Including Sexual Harassment, Discrimination and Retaliation Prevention Policy & Documents
Harassment, Including Sexual Harassment, Discrimination & Retalition Prevention Policy
Harassment Discrimination and Retaliation Acknowledgement Form - Form 2014.NMJB.120-A
Investigation Participant Acknowledgement Form - Form 2014.NMJB.120-B
Harassment Discrimination and Retaliation Complaint Form - Form 2014.NMJB.120-C
Training DVDs Acknowledgement Form - Form 2014.NMJB.120-D
Harassment Policy Flow Chart - Form 2014.NMJB.120-E