Employment Forms

Employment Package​

• New Hire C​hecklist  (8/10/23)​​
• Certification of Purchasing Service Credit
  
• Code of Ethics Certification of New Hire  (5/19)
• Ethics Post-Employment Guide   (4/2023)
  
• FLSA Exempt Form (Microsoft Word​​)​
  
• KPPA Form 6754 Member Re-em​ployment Certification​
  
• KY DOR Acknowledgment of Confidentiality Form  (5/2019)​
• Position Descriptio​n, Fill-in Form  (8/15/23)​​​
  
• ​Previous Qualifying Service Certification​
  
• ​State Application​ (10/19/2023)
  

Onboarding Forms​

• ​​PVA Onboarding Orientation Checklist​
• Direct Deposit Form *May be completed via KHRIS*​​
• Form I-9 Employment Eligibility Verification​
  
• Form K​-4 Employee State Withholding Allowance Certificate  
  
• Form W-4 Employee Federal Withholding Allowance Certificate
  
• KPPA Designation Form 2035 Beneficiary Designation
  
• KPPA Form 2001 Membership Information​
• Work Schedule Agreement  (1/27/23)​​​​​

​Insurance​​

• ​​​2024 Health Insurance Cross Reference Application ​​​
  
• 2024 Benefits Selection Guide​​
• Health Insurance *Must enroll via KHRIS*
  
• MetLife Insurance Enrollment/Change/Termination Form​
  

Optional Forms

• ​​Deferred Comp (opt out)​
• Outside Employment (4/20/23)​