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KSRE Employee Resources


K-State Research and Extension - Local Unit Forms

Form Topics

 

Benefits/ Payroll Information/ Leave Forms

Ext.Form File NameTitle & DescriptionUser Instructions
 Uniform Facsimile SignatureUniform Facsimile Signature
of Public Officials Act
 
logos>Printer LogoEXOP3-2.pdfOvertime Compensation Agreement for
 Non-Exempt Employees
Instructions
logos>pdfFMLA 1-1 to 1-4Family and Medical Leave Act Overview
(FMLA) & forms
Instructions
logos>pdfKSU1-11.pdfPayment of Health Care Premiums
for State of Kansas Employee Health
Care Program for Non-State Groups
Instructions
logos>pdfKSU1-11b.pdfNotice of Intent to Participate in the State of Kansas Health Care Program for
Non-State Groups
Instructions
logos>pdf

KSU1-12.pdf

Bank Draft Approval for State of Kansas
Employee Health Care Program for
Non-State Group
Instructions
logos>xlsKSU8-25.xlsRecord of Hours Worked and Leave for
Office Professionals
(Excel)
Instructions
logos>Printer LogoKSU8-25.pdfRecord of Hours Worked and Leave for
Office Professionals
(Print Only)
Instructions
logos>pdfKSU8-32.pdfConsulting Request for Use by Extension AgentsInstructions
ExcelKSU8-42.xlsLocal Unit Employee Leave Monthly SummaryInstructions
pdfPR-5 FY 2018Unclassified Annual and Sick Leave Record
for FY 2018
Instructions
ExcelPR-5 FY 2018Unclassified Annual and Sick Leave Record
for FY 2018 (Excel)
Instructions
For Classified Annual & Sick Leave Forms visit Division of Human Capital Services -
Forms Page
(Leave Record)
 

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Budgets and Financial Forms

Ext.Form File
Name
Title & DescriptionUser
Instructions
logos>pdfGAAP1-1 & 1-2.pdf
 
Generally Accepted Accounting Principles
(GAAP) Waiver Resolution for Extension
Councils and District Governing Bodies
Instructions
logos>pdfKSU1-13.pdfExtramural Funds Approval Form 
logos>pdfKSU1-14.pdfElectronic Funds Transfer AuthorizationInstructions
logos>pdfKSU1-18.pdfDirect Deposit of Salary AuthorizationInstructions
logos>Printer LogoKSU4-1 to 4-4- Financial Review Committee Responsibilities
- Financial Review Checklist
- Annual Financial Report
- 4-H Club Treasurer Job Description
Instructions
logos>pdfKSU8-1.pdfBudget for County Extension CouncilInstructions
logos>pdfKSU8-2.pdfCertificate of Filing County Extension
Budget
Instructions
logos>Printer LogoKSU8-3.pdfCertificate of Appropriation - Print OnlyInstructions
ExcelKSU8-6, 8-7a, 8-7b, 8-9Financial Summary Forms for QuickBook UsersInstructions
logos>pdfKSU8-10.pdfCounty Equipment InventoryInstructions
logos>xlsKSU8-10.xlsCounty Equipment Inventory
(Excel)
Instructions
logos>xlsKSU8-19.xlsFinancial Check Sheet with Budget
Development and Management
Worksheets
(Excel)
Instructions
logos>pdfKSU8-34.pdfTransfer of Property and Funds
(From County Extension Councils to
Extension Districts)
Instructions
logos>pdfKSU8-35.pdfInvoiceInstructions
logos>xlsKSU8-37.xlsSalary Proposal WorksheetInstructions
logos>xlsKSU8-39.xlsExtension Council/District Staff
Salary and Benefits Record
Instructions
logos>xlsKSU8-41.xlsProgram/Service Costs Calculation
Worksheets (On-Campus and Off-Campus)
Instructions
pdfKSU8-44 a and bChange Fund Authorization/Maintenance,
Reconciliation of Change Fund and Policy
Instructions
pdfKSU8-45 a and bRaffle Application, Raffle Final Report, Sample and PolicyInstructions
logos>pdfKSU9-10.pdfDistrict Equipment InventoryInstructions
logos>xlsKSU9-10.xlsDistrict Equipment Inventory
(Excel)
Instructions
logos>xlsKSU9-19.xlsDistrict Financial Check Sheet with
Budget Development & Management
Worksheets (Excel)
Instructions

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Civil Rights Forms

Ext.Form File NameTitle & DescriptionUser Instructions
logos>pdfCR-1Annual Civil Rights Mini-Review 
logos>pdfCR-2

Civil Rights Program Compliance Review Guide 2010-2013


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Crisis Management Forms

Ext.Form File NameTitle & DescriptionUser Instructions
PrintAdult Health FormVoluntary Adult Health Information Form 
logos>pdfKSU8-33.pdfCrisis Management PlanningInstructions
logos>pdfKSU8-33a.pdfCrisis Management Planning -
Pocket Form
Instructions

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Employment Forms

Ext.Form File NameTitle & DescriptionUser Instructions
logos>Conflict of
Interest
Declaration of Conflict of Interest and
Time Commitment Forms - KSU
Instructions
logos>pdfEXOP3-5Approval to Employ an Extension Program AssistantInstructions
logos>Printer LogoEXOP3-9Screening of Office Professional and Program Assistant Applicants Prior to Interview
(Print Only)
Instructions
logos>pdfEXOP3-11Employment Agreement
Office Professionals and Program Assistants
Instructions
logos>pdfEXOP3-13Employee Performance Review
Office Professionals and Program Assistants
Instructions
logos>pdfEXOP3-15Personnel Action Form
(For Area Office Use Only)
Instructions
logos>pdfEXOP3-16Extension Agent Exit InterviewInstructions
logos>pdfEXOP3-17Employee Separation Checklist
for Local Unit
Instructions
logos>pdfEXOP3-18Exit Interview
Office Professional and Program Assistant
Instructions
logos>pdfKSU1-2.pdfExtension Agent Employment AgreementInstructions
logos>pdfKSU1-16.pdfArea Specialist Performance Appraisal
Input Form
Instructions
logos>xlsKSU1-17.xlsRecruiting/Offer FormInstructions
logos>pdfKSU8-29OP.pdfOffice Professional - Application for EmploymentInstructions
logos>pdfKSU8-29PA.pdfProgram Assistant - Application for EmploymentInstructions
 Link to LoginAnnual Extension Agent Performance Review
Electronic Version
 
pdfKSU8-30a.pdfBoard Member Agent Evaluation 
logos>pdfKSU8-30c.pdfOptional Annual Extension Agent Performance
Review:  External Feedback
Instructions
ExcelKSU8-43.xlsProgram Staffing Plan Spreadsheet 
pdfKSU8-46.pdfExtension Agent Self-Evaluation 
pdfKSU8-47.pdfOrganizational Leadership and
Citizenship Summary
 
 KSU8-48Performance Review Narrative
(Word Document)
Instructions

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Extension Council and Governing Body Forms

Ext.Form File NameTitle & DescriptionUser Instructions
 Memorandum of Understanding

Memorandum of Understanding

 
logos>Printer LogoKSU8-38.pdf

Template for Extension Board Meeting Minutes

Instructions
PDFKSU8-40.pdfExcellence in Board Leadership
Board Assessment
 
logos>publishMaking a DifferenceMaking a Difference Template - Local UnitsInstructions
logos>publishMaking a Difference Template - SAMPLE

Making a Difference Template - Local Units
SAMPLE

 
logos>pdfPM1
 
Handbook for County Extension Councils
and District Governing Bodies
Instructions
 Council Forms  
logos>pdfKSU8-4a.pdf

 
Extension Council Executive Board
Members and County Extension Council
Members elected by Commissioner Districts
Instructions
logos>pdfKSU8-4b.pdf
 
Extension Council Executive Board
and County Extension Council
Members elected At Large
Instructions
logos>xlsKSU8-4a&b.xlsExtension Council Executive Board Members and County Extension Council Members
(Excel)
Instructions
logos>pdfKSU8-10.pdfCounty Equipment InventoryInstructions
ExcelKSU8-10.xlsCounty Equipment Inventory
(Excel)
Instructions
logos>pdfKSU8-15.pdfExtension Council Member RecordInstructions
logos>xlsKSU8-15.xlsExtension Council Member Record - ExcelInstructions
logos>pdfKSU8-20.pdfOath to support U.S. and Kansas
Constitution, County Version
Instructions
logos>pdfKSU8-23.pdfPublic Notice of Annual Meeting of County
Extension Council
Instructions
logos>pdfKSU8-24a.pdfPublic Notice of Extension Council Election
at Large
Instructions
logos>pdfKSU8-24.pdfPublic Notice of Extension Council Elections
at Three Locations
Instructions
 District Forms  
logos>pdfKSU8-34.pdfTransfer of Property and Funds
(From County Extension Councils to
Extension Districts)
Instructions
ExcelKSU 9-4.xlsGoverning Board of the Extension District
(Excel)
Instructions
logos>pdfKSU9-4.pdf
 
Governing Board of the Extension DistrictInstructions
logos>pdfKSU9-5.pdfDistrict Operational AgreementInstructions
logos>pdfKSU9-6.pdfDistrict Office Space AgreementInstructions
logos>pdfKSU9-10.pdfDistrict Equipment InventoryInstructions
logos>xlsKSU9-10.xlsDistrict Equipment Inventory
(Excel)
Instructions
logos>pdfKSU9-15.pdfGoverning Body Member RecordInstructions
ExcelKSU9-15.xlsGoverning Body Member Record - ExcelInstructions
logos>pdfKSU9-20.pdfOath to support U.S. and Kansas
Constitution, District Version
Instructions

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Master Farmer - Master Farm Homemaker Forms

Ext.Form File NameTitle & DescriptionUser Instructions
logos>pdfKSU1-10.pdf
 
Kansas Master Farmer-Master Homemaker
Workbook 
Instructions

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Sabbatical and Study Leave Application Forms

Ext.Form File NameTitle & DescriptionUser Instructions
logos>pdfApplication
 
Application for Sabbatical Leave from
Kansas State University
 
logos>pdfGuidelinesGuidelines for Sabbatical Leave from
Kansas State University
 
logos>pdfKSU1-9c.pdf
 
Application for Study Leave other
than Sabbatical Leave
Instructions

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Travel Forms

 Form File NameTitle & DescriptionUser Instructions
logos>pdfKSU8-17.pdfTravel Payment VoucherInstructions
PrintPPM 6420.160 & 170Vehicle Daily LogInstructions

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