Human Resources Forms | Cobb County Georgia

A

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Acknowledgment of Receipt of Attendance ID# and Responsibilities	AFLAC Wellness Accident Plan
Acknowledgment of Receipt	AFLAC Wellness Cancer Plan
Advance Request	AMS Financial
AFLAC Accidental Insurance Claim	Annual Leave Donation
AFLAC Short-Term Disability: Accidental Injury	Authorization for Release of Information
AFLAC Short-Term Disability: Sickness

B

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Benefit Election Change

C

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Concentra Authorization	COVID-19 Employee Health Screening Form
ConTrans Request (County Attorney's Office)	Credit Check Authorization

D

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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

E

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Elections Poll Worker Sign Up	Employee Absence Worksheet
Emergency Paid Administrative Leave (EPAL)	Employee Information Change
Emergency Procurement Request	Employee Reimbursement (Finance)

F

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Firefighter Cancer Continuation Coverage Enrollment	Friendship Club Enrollment/Stop
Fleet Bus Pool Use Request	FMLA – Certification of Healthcare Provider – Employee
Flex Plan Dependent Card Request	FMLA – Certification of Healthcare Provider – Family Member
Flexible Benefits Enrollment and Change	FMLA – Designation Notice
Flex Plan Reimbursement Request - MEDCOM	FMLA – Notice of Eligibility and Rights & Responsibilities
Flower Fund	Fuel Authorization

G

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G-4 State Withholding

GAX Payment

H

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Hotel/Motel Tax Exemption Request

I

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

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I-9 (Employment Eligibility Verification Department of Homeland Security)	(IS) Non-Employee Access Request
ICMA-RC forms can be found under MissionSquare in the "M" section.	(IS) Request for Quote (Hardware/Software)
(IS) Change/Transfer Employee Access Request	(IS) User Account Request (Contexte)
(IS) Disable Active Directory Account Request	(IS) User Account Request (OnBase)
(IS) Employee Name Change Request	(IS) Vendor/Contractor VPN Connectivity Request
(IS) Employee VPN/Email Connectivity Request	(IS) Visitor Log (blank)
(IS) New Employee Access Request	Intern and Volunteer

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 Mission Square 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

P

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Parental Authorization Emergency Medical Treatment	Post-Payroll Adjustment
Performance Appraisal--Located in Quick Links on iCobb	Pre-Payroll Adjustment
Performance Appraisal Instructions - Supervisor	Pre-Performance Appraisal Discussion Memo
Petty Cash	Prescription Claim Form
Physical Requirements	Progress Discussion
Police Department Training Request	Progress Discussion Instructions

R

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Request to Review Employee File	Retirement - Request for Pension Estimate
Requisition for Interns or Volunteers	Risk Management Request for Motor Vehicle Report
Restoration of Prior Service Request	Routing Cover Sheet
Restricted Hiring

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

Vendor Application

W

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