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)

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
Flexible Benefits Enrollment and Change	FMLA – Designation Notice
Flex Plan Reimbursement Request - MEDCOM	FMLA – Notice of Eligibility and Rights & Responsibilities
Flower Fund	Fraternal Order of Police Payroll Deduction
Friendship Club	Fraternal Order of Police Payroll Deduction Cancellation
FMLA – Certification of Healthcare Provider – Employee	Fuel Authorization
FMLA – Certification of Healthcare Provider – Family Member

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.

Please note: Some Seamless Docs forms may require you to forward the document via email.

I-9	(ITS) Reenable Active Directory Account Request
(ITS) Change/Transfer Employee Access Request	(ITS) Request for Quote (Hardware/Software)
(ITS) Disable Active Directory Account Request	(ITS) Request to Add Non-County Device to Cobb Network
(ITS) Email Access on Mobile Device	(ITS) User Account Request (Contexte)
(ITS) Employee Name Change Request	(ITS) User Account Request (OnBase)
(ITS) New Employee Access Request	(ITS) VPN Access Request
(ITS) New Position – Technology Request	(ITS) Visitor Log (blank)
(ITS) Non-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 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)

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 Request for Renovation
Police Department Training Request

R

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

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
	Veterans DD Form 214

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-4 Video	Workers' Comp Panel of Physicians (Scroll to the 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 the 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