HR Forms Directory - Pinal County

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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 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

Direct Deposit Form

Flexible Schedule Agreement

Outside Employment Declaration

Pinal County Change of Address-Name

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

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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