K-State Research and Extension - Local Unit Forms
| Ext. | Form File Name | Title & Description | User Instructions |
 | Conflict of Interest | Declaration of Conflict of Interest and Time Commitment Forms - KSU | Instructions |
 | Application and Guidelines for Sabbatical Leave | ||
 | Making a Difference Template - Local Units | Instructions | |
 | Adult Health Form | Voluntary Adult Health Information Form | |
| | Memorandum of Understanding | Memorandum of Understanding | |
 | Suggested Agent Board Report | Suggested Agent Board Report and Template | |
| | Uniform Facsimile Signature Act and Form | Uniform Facsimile Signature of Public Officials Act | |
| CR - 1 | Annual Civil Rights Update | |
| CR - 2 | Civil Rights Program Compliance Review Guide 2020 | |
| CR - 3 | Demographics Data Collection Form | |
| Overtime Compensation Agreement for Non-Exempt Employees | Instructions | |
| EXOP3-5 | Approval to Employ an Extension Program Assistant | Instructions |
| EXOP3-9 | Screening of Office Professional and Program Assistant Applicants Prior to Interview (Print Only) | Instructions |
| | EXOP3-11 | Employment Agreement Office Professionals and Program Assistants | Instructions |
| EXOP3-12 | Orientation Checklist for Local Unit | Instructions |
| | EXOP3-13 | Employee Performance Review Office Professionals and Program Assistants | Instructions |
| EXOP3-15 | Personnel Action Form (For Regional Office Use Only) | Instructions |
| EXOP3-16 | Extension Agent Exit Interview | Instructions |
| EXOP3-17 | Employee Separation Checklist for Local Unit | Instructions |
| EXOP3-18 | Exit Interview Office Professional and Program Assistant | Instructions |
| FMLA1-1 to 1-4 | Family and Medical Leave Act Overview (FMLA) & forms | Instructions |
| GAAP1-1 & 1-2.pdf | Generally Accepted Accounting Principles (GAAP) Waiver Resolution for Extension Local Unit Boards | Instructions |
| KSU1-9c.pdf | Application for Study Leave other than Sabbatical Leave | Instructions |
| Kansas Master Farm Family Nomination | Instructions | |
| KSU1-11.pdf | Payment of Health Care Premiums for State of Kansas Employees Health Care Program for Non-State Groups | Instructions |
| KSU1-11b.pdf | Notice of Intent to Participate in the State of Kansas Health Care Program for Non-State Groups | Instructions |
| KSU1-12.pdf | Bank Draft Approval for State of Kansas Employee Health Care Program for Non-State Groups | Instructions |
| KSU1-13.pdf | Extramural Funds Approval Form | |
| KSU1-14.pdf | Electronic Funds Transfer Authorization | Instructions |
| KSU1-16.pdf | Area Specialist Performance Appraisal Input Form | Instructions |
| KSU1-18.pdf | Direct Deposit of Salary Authorization | Instructions |
| KSU1-2a.pdf | Employees Agreement (Counties with three or fewer Agents) | Instructions |
| KSU1-2b.pdf | Employees Agreement (Counties with four more Agents and all Districts) | Instructions |
| KSU1-2c.pdf | Local Unit EFNEP Agent Agreement | Instructions |
| KSU4-1 | - Financial Review Committee Responsibilities for 4-H Club/Group and Other Extension Affiliated Accounts | Instructions |
| KSU4-2 | 4-H Club/Extension Group Financial Review Checklist | Instructions |
| KSU4-3 | 4-H Club/Extension Affiliated Group Annual Financial Report | Instructions |
| KSU4-4 | 4-H Club Treasurer Job Description | Instructions |
| KSU8-1.pdf | Budget for County Extension Council | Instructions |
| KSU8-2.pdf | Certificate of Filing County Extension Budget | Instructions |
| KSU8-3.pdf | Certificate of Appropriation (Print Only) | Instructions |
 | KSU8-4a&b.xlsx | Extension Council Executive Board Members & County Extension Council Members (Excel) | Instructions |
| KSU8-6, 8-7a, 8-7b & 8-9 | Financial Summary Forms for QuickBook Users | Instructions |
| KSU8-10.pdf | Equipment Inventory | Instructions |
| KSU8-10.xls | Equipment Inventory (Excel) | Instructions |
| KSU8-15.pdf | Extension Council Member Record | Instructions |
| KSU8-15.xls | Extension Council Member Record - Excel | Instructions |
| KSU8-17.pdf | Travel Payment Voucher | Instructions |
| KSU8-19.xls | County Financial Check Sheet with Budget Development & Management Worksheets (Excel) | Instructions |
| KSU8-20.pdf | Oath to Support U.S. and Kansas Constitution (County Version) | Instructions |
| KSU8-23.pdf | Public Notice of Annual Meeting of County Extension Council | Instructions |
| KSU8-24a.pdf | Public Notice of Extension Council Election at Large | Instructions |
| KSU8-24.pdf | Public Notice of Extension Council Election at Three Locations | Instructions |
| KSU8-25.xls | Record of Hours Worked & Leave for Office Professionals (Excel) | Instructions |
| KSU8-25.pdf | Record of Hours Worked & Leave for Office Professionals (Print Only) | Instructions |
| KSU8-29OP.pdf | Office Professional Application for Employment | Instructions |
| KSU8-29PA.pdf | Program Assistant Application for Employment | Instructions |
| KSU8-30c.pdf | Optional Annual Extension Agent Performance Review: External Feedback | Instructions |
| KSU8-32.pdf | Consulting Request for Use by Extension Agents | Instructions |
| Crisis Management Planning | Instructions | |
| KSU8-33a.pdf | Crisis Management Planning (Pocket Form) | Instructions |
| KSU8-34.pdf | Transfer of Property and Funds (From County Extension Councils to Extension Districts) | Instructions |
| KSU8-35.pdf | Invoice | Instructions |
| KSU8-36.pdf | Preferred Vehicle Log for Local Units | Instructions |
| KSU8-37.xls | Salary Proposal Worksheet | Instructions |
| KSU8-38.pdf | Template for Extension Board Meeting Minutes | Instructions |
| KSU8-39.xlsx | Extension Council/District Staff Salary and Benefits Record | Instructions |
| KSU8-40.pdf | Excellence in Board Leadership Board Assessment | |
| KSU8-41.xls | Program/Service Costs Calculation Worksheets (On-Campus & Off-Campus) | Instructions |
| KSU8-42.xls | Local Unit Employee Leave Monthly Summary | Instructions |
| KSU8-43.xls | Program Staffing Plan Spreadsheet | |
| KSU8-44 a & b | Change Fund Authorization/Maintenance, Reconciliation of Change Fund and Policy | Instructions |
| KSU8-45 a & b | Raffle Application, Raffle Final Report, Sample and Policy | Instructions |
| KSU8-47.pdf | Organizational Leadership and Citizenship Summary | |
| KSU8-48.wpd | Performance Review Narrative (Word Document) | Instructions |
| KSU8-49.pdf | Local Unit Extension Board/PDC Member Change Form | Instructions |
| KSU8-50.xlsx | Agent & Staff Benefit Profile | Instructions |
| KSU9-4.xlsx | Governing Board of the Extension District (Excel) | Instructions |
| KSU9-6.pdf | District Office Space Agreement | Instructions |
| KSU9-10.pdf | District Equipment Inventory | Instructions |
| KSU9-10.xls | District Equipment Inventory (Excel) | Instructions |
| KSU9-15.pdf | Governing Body Member Record | Instructions |
| KSU9-15.xls | Governing Body Member Record - Excel | Instructions |
| KSU9-19.xls | District Financial Check Sheet with Budget Development & Management Worksheets (Excel) | Instructions |
| KSU9-20.pdf | Oath to Support U.S. & Kansas Constitution (District Version) | Instructions |
| PM1 | Handbook for County Extension Councils & District Governing Bodies | Instructions |
| PPM 6420.160 & 170 | Vehicle Daily Log for State Use | Instructions |
| PR-5 FY2022.pdf | Unclassified Annual & Sick Leave Record for FY 2022 | Instructions |
| PR-5 FY2022.xls | Unclassified Annual & Sick Leave Record for FY 2022 (Excel) | Instructions |
| For Classified Annual & Sick Leave Forms visit Division of Human Capital Services - Forms Page (Leave Record) | |||
KSRE Business Office Forms - For Administration Use Only | |||
| Recruit Budgeted | Request to Recruit for Faculty and Unclassified BUDGETED Position &/or New Position Number | |
| Recruit Non-Budgeted | Request to Recruit for NON-BUDGETED Position &/or New Position Number | |
| KSU1-17 | Recruiting/Offer Form | Instructions |
For Information on Portable Document Format (pdf) files visit www.ksu.edu/tools/pdf webpage.
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