State Personnel Department Forms
To search this catalog: From the toolbar in the Edit menu, select "Find". When the Find search box appears, enter a keyword or form number. The first search result will display with the keyword or number highlighted, at the top of the page. Click "Find next" until the desired form is highlighted.
For forms labeled "PDF", the free Adobe Acrobat Reader software is required to view and in some cases fill them out. Forms in other formats (MS Word, MS Excel, etc) are indicated where appropriate.
To open a form once you have chosen it, click on the linked State Form Number (such as 01365.pdf).
For questions about individual forms, please contact this agency's forms coordinator, Heather McManamon at 317-233-8889.
For questions about how to use this catalog, or to inform us of a technical problem, please send e-mail to the
Forms marked "read-only" cannot be filled in on your computer. They must be printed out and filled in by hand or typewriter.
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Title |
Form Number |
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Applicant Background Record Checklist |
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Applicant Background Record Checklist |
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Applicant Disclosure and Release for Consumer and Investigative Consumer Reports |
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Applicant Disclosure and Release for Consumer and Investigative Consumer Reports |
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Application to Participate (Retiree Flexible Spending Program) (read-only) |
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Attending Physician's Statement (read-only) |
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Attending Physician's Statement |
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Benefit Correction Request |
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Benefit Correction Request |
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Deletion of Coverage Notice for Carriers (read-only) |
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Employee Attendance Report (A-4) |
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Employee Attendance Report (A-4) |
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Employee Benefits Application (read-only) |
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Employee Compensatory Time Worksheet |
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Employee Performance Appraisal Comments Sheet |
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Employee Performance Appraisal Comments Sheet |
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Employee Performance Appraisal Report Executive, Supervisory, & Managerial (read-only) |
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Employee Performance Appraisal Report Executive, Supervisory, & Managerial |
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Employee Performance Appraisal Report Non-Supervisory / Non-Exempt Employees (read-only) |
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Employee Performance Appraisal Report Non-Supervisory / Non-Exempt Employees |
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Employee Performance Appraisal Report Non-Supervisory Professional (read-only) |
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Employee Performance Appraisal Report Non-Supervisory Professional |
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Employee's Authorization for Release of Medical Information (read-only) |
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Employee's Authorization for Release of Medical Information |
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Employee's Claim Statement (read-only) |
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Employee's Claim Statement |
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Employee Work Profile / Performance Plan (read-only) |
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Employee Work Profile / Performance Plan |
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Employer's Report of Claim (read-only) |
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Employer's Report of Claim |
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Evaluation of Training (read-only) |
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Indiana State Employee Suggestion Program Submission |
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Instructions for Submission of a Disability Claim (read-only) |
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Instructions for Submission of a Disability Claim |
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Intent to Participate (Retiree Flexible Spending Program) (read-only) |
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Interim Performance Appraisal (read-only) |
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Interim Performance Appraisal |
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Job Analysis Questionnaire |
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Job Analysis Questionnaire |
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Job Description (read-only) |
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Job Description |
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Leave Notice for Benefit (read-only) |
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Merit Employee Complaint (read-only) |
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Merit Employee Complaint (read-only) |
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Options Statement |
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Personnel / Payroll Action |
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Personnel / Payroll Action |
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Request for Re-Employment (read-only) |
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Request for Re-Employment |
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State Employee Community Service Program Request for Leave and Verification of Services Provided |
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Vision Benefits Enrollment / Change Form (read-only) |
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Verification of Dependent Disability (read-only) |
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Verification of Full Time Student Status (read-only) |
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Work Improvement Plan (read-only) |
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Work Improvement Plan |
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