Forms
Frequently Requested
Benefit Related
(health insurance, leave, worker’s compensation)
Benefits Change of Address Form (Please use myOleMiss to make address changes. This form is to be used only if you do not have access to myOleMiss.)
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PDF Document |
UNUM Beneficiary Designation Form |
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PDF Document |
State Life Insurance Beneficiary Designation |
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PDF Document |
AD&D Beneficiary Designation Form |
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PDF Document |
Insurance Claim Form for Delta Dental |
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Link |
Insurance Claim Form for Davis Vision |
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PDF Document |
Insurance Claim Form for Colonial Life and Accident |
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Link |
Insurance Claim Form for American Heritage Cancer and Intensive Care |
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PDF Document |
Insurance Claim Form for Medical Claim |
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PDF Document |
Mail Order Prescriptions |
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PDF Document |
Request for Reimbursement Form for Flexible Spending Accounts with Southern Administrators & Benefit Consultants |
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PDF Document |
Dependent Care Receipt Form |
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Link |
Change of Information for the Public Employees’ Retirement System |
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PDF Document |
Public Employees’ Retirement System of MS Beneficiary Designation Form |
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PDF Document |
Workers Compensation Injury Report Packet |
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PDF Document |
Medical Certification Form |
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PDF Document |
Reasonable Suspicion Form |
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PDF Document |
E-form Administration
E-form program on myOleMiss |
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Link |
E-form Guides and Information |
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Link |
Request Access to E-form |
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Link |
Flexible Work Location (Telework & Remote Work)
Payroll
Recruitment
For Recruitment related documents and forms, please use your Ole Miss webID and password to login to connectU (connectu.olemiss.edu). These below documents can be found by selecting the “Click Here for connectU Resources” box..
- Search Committee Guide
- Job Requisition Intake Form
- Sample Interview Questions
- Sample Reference Check Questions
- Confidentially Agreement
Separation of Employment
The following can be accessed at my.olemiss.edu.
- Address Change
- W-2 Opt-In
- W-2
- Pay Stubs
- Timesheets
- Office Contact Information
- Emergency Contact Information
- Bank Information
- Travel
- Benefits Confirmation Statement
- Open Enrollment