Human Resources Forms | Cobb County Georgia

A

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ADA Request for Accommodation	Aflac Claims
ADA Request Medical	Annual Leave Donation
Acknowledgment of Receipt	Authorization for Release of Information
Advance Request

B

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Benefit Election Change

C

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Concentra Authorization	Credit Check Authorization
ConTrans Request (County Attorney's Office)

D

Links with this icon go to an internal Cobb County network site.

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DPS Travel/Training Request	Direct Deposit Deduction (for additional Direct Deposit Deductions)
Dental Claim	Documentation Card
Department Operations Feedback	Drug Notification
Direct Deposit Authorization	Drug Notification (DPS only)

E

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Elections Poll Worker Sign Up	Employee Emergency Alerts Opt-in
Emergency Procurement Request	Employee Information Change
Employee Absence Worksheet	Employee Reimbursement (Finance)
Employee Complaint

F

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Firefighter Cancer Continuation Coverage Enrollment	FMLA – Certification of Healthcare Provider – Military Caregiver
Flex Plan Dependent Card Request	FMLA – Certification of Healthcare Provider – Military Exigency
Flex Enrollment and Change Form	FMLA - Certification of Healthcare Provider - Veteran Caregiver
Flex Plan Reimbursement Request - MEDCOM	FMLA – Designation Notice
Flower Fund	FMLA – Notice of Eligibility and Rights & Responsibilities
Friendship Club	Fraternal Order of Police Payroll Deduction Cancellation
FMLA – Certification of Healthcare Provider – Employee	Fraternal Order of Police Payroll Deduction Enrollment
FMLA – Certification of Healthcare Provider – Family Member	Fuel Authorization

G

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G-4 State Withholding

GAX Payment

H

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Hotel/Motel Tax Exemption Reques t

I

Links with this icon go to an internal Cobb County network site.

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I-9	(ITS) Reenable Active Directory Account Request
(ITS) CCSO Jail Site Access	(ITS) Request for Quote (Hardware/Software)
(ITS) Change/Transfer Employee Access Request	(ITS) Request to Add Non-County Device to Cobb Network
(ITS) Disable Active Directory Account Request	(ITS) User Account Request (Contexte)
	(ITS) User Account Request (OnBase)
(ITS) Employee Name Change Request	(ITS) VPN/CobbEmpAcc Wi-Fi Access Request
(ITS) New Employee Access Request	(ITS) Visitor Log (blank)
(ITS) New Position – Technology Request	Intern and Volunteer
(ITS) Non-Employee Access Request

K

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Key Request	Kronos Schedule Building Instructions
Kronos Clock Instructions	Kronos Teletime Phone Instructions
Kronos PC Instructions	Kronos Time Editor Acknowledgement and Access Authorization

L

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Leave Request

Life Insurance Beneficiary Designation

M

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*MissionSquare Retirement forms can be found on the MissionSquare website.

Manual Check Request - Accounts Payable	Mission Square 457 Traditional Enrollment*
Manual Check Request - Payroll	MissionSquare Cobb County Investment Options*
Medical Handicapped/Disabled Member Certification (Blue Cross)	MissionSquare Hybrid Enrollment 457/401 Plan*
Medical Questionnaire	MissionSquare Roth IRA Application*
Military Service Credit Request	MissionSquare Terms and Advisory Agreement*
Miscellaneous Transaction	MissionSquare Trustee-to-Trustee Transfer to the MissionSquare Retirement Packet*
MissionSquare 457 Deferred Contribution Change*	Motor Vehicle Record Release

N

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New Hire Information Sheet

New Employee Information Sheet (Non-NeoGov)

O

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Open Records/GovQA User Request

P

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Parental Authorization Emergency Medical Treatment	Post-Payroll Adjustment
Performance Management Task Transfer	Pre-Payroll Adjustment
Petty Cash	Prescription Claim Form
Physical Requirements	Property Mgmt Cityworks Access Request
Police Department Training Request	Property Mgmt Request for Renovation

R

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Real Property Transactions	Restricted Hiring
Request to Review Employee File	Retirement - Request for Pension Estimate
Requisition for Interns or Volunteers	Routing Cover Sheet
Restoration of Prior Service Request

S

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Secondary Employment	Sole Source Request
Sedition and Subversive Activities Questionnaire	Suggestion Incentive
Separation from Service	Surplus Property

T

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T6 Sales Tax Exemption	Training Evaluation
Telework Agreement	Travel Documents
Terminal Leave Payroll Request	Tuition Assistance Application
Training Attendance Sheet	Tuition Assistance Course Enrollment
Training Enrollment

U

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Unclassified Position & Command Staff Appointments

V

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Vehicle Inspection	Veterans DD Form 214
Vendor Application	Vision Enrollment

W

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W-2 Reprint	Workers' Comp Mileage Request
W-4 Employee's Withholding Allowance Certificate	Workers' Comp Online Claims Submission Instructions
W-9 Request for Taxpayer Identification Number and Certification	Workers' Comp Panel of Physicians (Scroll to the bottom of Policies page)
Work Schedule Change Request Workers' Comp Acknowledgement	Workers' Comp Pharmacy Card
Workers' Comp Bill of Rights (scroll to the bottom of Policies page)	Worker's Comp Pharmacy Partnership
Workers' Comp Employer’s Supplemental Report of Injury	Workers' Comp Statement of Understanding
Workers' Comp Hazardous Duty Injury	Workers' Comp Supervisor's Investigation Report
Workers' Comp Injury Report	Workers' Comp Treatment Authorization
	Working Test Period Appraisal