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Listed below are the various forms that Human Resources has made available for download. All forms are in Adobe Acrobat (PDF) format and will require that you print, fill out, and fax/mail back if necessary. Related links can be found at the bottom of this page to external websites.

Appraisal Forms 
Evaluation Form
SMART Goal Sheet
Benefit Forms 
AF Flex Claim Instructions
AzMT Basic Dental Summary of Benefits
AzMT Buy-Up Dental Summary of Benefits
AzMT EPO Plan
AzMT EPO SBC
AzMT HDHP Plan
AzMT HDHP SBC
AzMT PPO Buy-Up Plan
AzMT PPO Buy-Up SBC
Benefits Change Form 2018 - 2019
Change of Beneficiary Form
Employee HSA Payroll Deduction
Mail Order - Costco Mail Order Form
Short-Term Disability Benefit Summary
Short-Term Disability Claim Form
The Standard Beneficiary Form
Employee Acknowledgement Forms 
Cell Phone Usage Acknowledgment Form
Personnel Status Change Form
Telework Policy Agreement
Employee Information Forms 
A-4 Form
Direct Deposit Form
Flexible Schedule Agreement
Outside Employment Declaration
Pinal County Change of Address-Name
W-4 Form
Family & Medical Leave Forms 
Certification for Serious Injury Illness of a Current Service Member--For Military Family Leave - WH 385
Certification of Health Care Provider for Employee Medical Leave - WH 380-E
Certification of Health Care Provider for Family Medical Leave - WH 380-F
Certification of Qualifying Exigency For Military Family Leave - WH-384
Certification of Serious Injury Illness of a Veteran--For Military Caregiver Leave - WH 385-V
FMLA Tracking Form
New Hire Orientation Forms 
Compensatory Time Agreement
Drug Free Workplace Policy Statement
Fitness Center Waiver Form
I-9 Form
Loyalty Oath
New Employee Questionnaire
Personnel Policy Receipt Acknowledgment
Policy Acknowledgement
Statement of Use and Confidentiality
Public Records Request Forms 
Verified Statement of Commercial Purpose
Verified Statement of Non-Commercial Purpose
Reclassification Forms 
Essential Functions Questionnaire
Position Description Questionnaire (PDQ)
Supervisory Position Supplemental Questionnaire
Retirement Forms 
2017 NRS Health Care Fact Finder
ASRS Long Term Disability Application
ASRS Return to Work Form
AZ Direct_rollover
NACo Participation Agreement
Nationwide Beneficiary Change Form
Nationwide Deferred Comp Enrollment and Change Form
Nationwide Retirement Options Booklet
NW Name Address Beneficiary Change Form
NW Payroll Authorization Change Form
PSPRS - Address and Name Change Form
Termination Forms 
Authorization for the Release of Information
Exit Interview Form
Resignation Letter
Separation Clearance Form
Training Related Forms 
Pinal County Tuition Reimbersement Program Application 2010
Training Service Agreement
Training Service Commitment
Tuition Service Agreement
Vacation & Other Leave Forms 
Families First Coronavirus Response Act (FFCRA) Leave Request Forms
Sabbatical-Single Period Leave Form
Time Off Request
Vacation Accrual Credit
Vehicle Forms 
Notification of Assignment of County Vehicle
Trip Exception Form
Vehicle Emergency Log
Vehicle Use Log
Volunteer Forms 
Volunteer Packet-Complete
Volunteer Service Agreement
Volunteer Status Checklist
Workers Compensation/Risk Forms 
ACIP Temporary Prescription Fill Form
Employee’s Report of a Vehicle/Equipment Accident
Exposure Instructions Sheet
Incident Report
Notice of Claim Against Pinal County
Notice of Claim Against Pinal County Spanish Version
Supervisors Report of Industrial Injury Instructions and Form
Supervisor's Vehicle Equipment Investigation Report

 

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