K-State Research and Extension - Local Unit Forms
| Form Topics |
Benefits/ Payroll Information/ Leave Forms
| Form File Name | Title & Description | User Instructions | |
 | Uniform Facsimile Signature Act and Form | Uniform Facsimile Signature of Public Officials Act | |
| EXOP3-2.pdf | Overtime Compensation Agreement for Non-Exempt Employees | Instructions |
 | KSU8-25.xls | Record of Hours Worked and Leave for Office Professionals (Excel) | Instructions |
| KSU8-25.pdf | Record of Hours Worked and Leave for Office Professionals (Print Only) | Instructions |
| KSU8-32.pdf | Consulting Request for Use by Extension Agents | Instructions |
| KSU8-42.xls | Local Unit Employee Leave Monthly Summary | Instructions |
| PR-5 FY 2024.pdf | Unclassified Annual and Sick Leave Record for FY 2024 | Instructions |
| PR-5 FY 2024.xls | Unclassified Annual and Sick Leave Record for FY 2024 (Excel) | Instructions |
| For Classified Annual & Sick Leave Forms visit Division of Human Capital Services - Forms Page (Leave Record) | |||
| Form File Name | Title & Description | User Instructions | |
| GAAP1-1 & 1-2.pdf | Generally Accepted Accounting Principles (GAAP) Waiver Resolution for Extension Local Unit Boards | Instructions |
| KSU1-13.pdf | Extramural Funds Approval Form | |
| KSU1-14.pdf | Electronic Funds Transfer Authorization | Instructions |
| KSU1-18.pdf | Direct Deposit of Salary Authorization | 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 |
| KSU8-6, 8-7a, 8-7b, 8-9 | Financial Summary Forms for QuickBook Users | Instructions |
| KSU8-10.pdf | County Equipment Inventory | Instructions |
| KSU8-10.xls | County Equipment Inventory (Excel) | Instructions |
| KSU8-19.xls | County Financial Check Sheet with Budget Development and Management Worksheets (Excel) | Instructions |
| KSU8-34.pdf | Transfer of Property and Funds (From County Extension Councils to Extension Districts) | Instructions |
| KSU8-35.pdf | Invoice | Instructions |
| KSU8-37.xls | Salary Proposal Worksheet | Instructions |
| KSU8-39.xlsx | Extension Council/District Staff Salary and Benefits Record | Instructions |
| KSU8-44 a and b | Change Fund Authorization/Maintenance, Reconciliation of Change Fund and Policy | Instructions |
| KSU8-45 a and b | Raffle Application, Raffle Final Report, Sample and Policy | Instructions |
| KSU8-50.xlsx | Agent & Staff Benefit Profile | Instructions |
| KSU9-10.pdf | District Equipment Inventory | Instructions |
| KSU9-10.xls | District Equipment Inventory (Excel) | Instructions |
| KSU9-19.xls | District Financial Check Sheet with Budget Development & Management Worksheets (Excel) | Instructions |
| Form File Name | Title & Description | User Instructions | |
| CR-1 | Annual Civil Rights Update | |
 | CR-2 | Civil Rights Program Compliance Review Guide 2020 | |
| CR-3 | Demographics Data Collection Form |
| Form File Name | Title & Description | User Instructions | |
| Adult Health Form | Voluntary Adult Health Information Form | |
| KSU8-33.pdf | Crisis Management Planning | Instructions |
| Form File Name | Title & Description | User Instructions | |
 | Conflict of Interest | Declaration of Conflict of Interest and Time Commitment Forms - KSU | 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 Office Professionals and Program Assistants | Instructions |
| EXOP3-20 | Background Check Request Office Professionals and Program Assistants | Send to Extension Operations office |
| EXOP3-13 | Employee Performance Review Office Professionals and Program Assistants | Instructions |
| EXOP3-17 | Employee Separation Checklist for Local Unit | Instructions |
| EXOP3-18 | Exit Interview Office Professional and Program Assistant | Instructions |
| KSU8-29OP.pdf | Office Professional - Application for Employment | Instructions |
| KSU8-29PA.pdf | Program Assistant - Application for Employment | Instructions |
| KSU8-43.xls | Program Staffing Plan Spreadsheet |
| Form File Name | Title & Description | User Instructions | |
| | Memorandum of Understanding | Memorandum of Understanding | |
| Suggested Agent Board Report | Suggested Agent Board Report | |
| KSU8-38.pdf | Template for Extension Board Meeting Minutes | Instructions |
| KSU8-40.pdf | Excellence in Board Leadership Board Assessment | |
| KSU8-49.pdf | Local Unit Extension Board/PDC Member Change Form | Instructions |
 | Making a Difference Template - Local Units and SAMPLE | Instructions | |
| PM1 | Handbook for County Extension Councils and District Governing Bodies | Instructions |
| County Forms | |||
| KSU8-4a&b.xlsx | Extension Council Executive Board Members and County Extension Council Members (Excel) | Instructions |
| KSU8-10.pdf | County Equipment Inventory | Instructions |
| KSU8-10.xls | County Equipment Inventory (Excel) | Instructions |
| KSU8-15.pdf | Extension Council Member Record | Instructions |
| KSU8-15.xls | Extension Council Member Record - 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 Elections at Three Locations | Instructions |
| District Forms | |||
| KSU8-34.pdf | Transfer of Property and Funds (From County Extension Councils to Extension Districts) | Instructions |
| KSU 9-4.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 |
| KSU9-20.pdf | Oath to support U.S. and Kansas Constitution, District Version | Instructions |
Master Farm Family Nomination Form
| Form File Name | Title & Description | User Instructions | |
| KSU1-10.pdf | Kansas Master Farm Family Nomination | Instructions |
Sabbatical and Study Leave Application Forms
| Form File Name | Title & Description | User Instructions | |
| Application and Guidelines for Sabbatical Leave from Kansas State University For Agents, approval of the Local Unit Board is also required for this application | ||
| KSU1-9c.pdf | Application for Study Leave other than Sabbatical Leave | Instructions |
| Form File Name | Title & Description | User Instructions | |
| KSU8-17.pdf | Travel Payment Voucher | Instructions |
| KSU8-36.pdf | Preferred Vehicle Log for Local Units | Instructions |
For Information on Portable Document Format (pdf) files visit www.ksu.edu/tools/pdf webpage.
If you do not have the Adobe Acrobat Reader, you may get the free download from the Adobe web site .
