MFC Forms Links: Human Resources, Financial Services, Management, Information, Protection, Property, Purchasing, Safety/Training, Other Sources

MFC Forms

(Note: Form # with a "e" in front of the form indicates that this form

can be filled out on line and printed. If no "e" is present, then the form

is designed to be printed and then filled out. )

Human Resource Forms
Form #	Form Name	Last Revised	Owner
e	Address and Emergency Data Information Form	6/2007	Personnel
e	Change of Address Form	6/2007	Personnel
e800-1	Performance Appraisal Review Report	1999	Personnel
e800-3	Duties Performances Statements	1999	Personnel
e801-1	Performance Review and Feedback Session	1999	Personnel
e802.1	Performance Improvement Plan	1999	Personnel
e	State Personnel Board - Job Content Questionnaire		Personnel

Financial Services Forms
Form #	Form Name	Last Revised	Owner
e	Authorization Agreement For Automatic Deposits (ACH Credits)	99-002	Payroll
e	Donor Leave Request	1/2008	Payroll
e101.1	Vehicle Usage Benefit		Financial Services
142.3	Deposit Slip	6/2005	Jennifer Head
142.4	Cash Receipt	6/2005	Jennifer Head
e143.1	Travel, Request -- Instructions Travel, Request Form	8/03 R1f	L. Wilkerson
e13.20.10	Travel Voucher	5/2005	L. Wilkerson
	Direct Bill Hotel	4/2009	L. Wilkerson
	Tax Exempt & Late Payment Memorandum	11/2008	Jennifer Head

Forest Management Forms
Form #	Form Name	Last Revised	Owner
e	FY09 Planting Survival Report	10/2008	B. Glasgow
	FY09 Tree Planting Compliance Form	10/2008	B. Glasgow
	BMP Inspection Form Instructions	6/2006	B. Frasier
	BMP Inspection Form	6/2006	B. Frasier
e	Public Lands Forest Products Price Report	7/2009	R. McInnis
601.4	Agreement for Partial Payment Under the FRDP Program		B. Glasgow
602.6	Limited Resource Landowner Affidavit	6/2003	B. Glasgow
e603.5	Forest Stewardship Landowner and Property Questionnaire		B. Godbold
e603.6	Forest Stewardship Demonstration Plan	2/3/09	B. Godbold
e603.7	Forest Stewardship Nomination Form	2/3/09	B. Godbold
e603.8	Forest Stewardship Certification Form	2/3/09	B. Godbold

Forest Information Forms
Form #	Form Name	Last Revised	Owner
	Routing Slip	5/19/2009	Lisa A. Harris
	State Office Phone List By Department	5/19/2009	Lisa A. Harris
e	Firewise Administrative Report	10/6/2009	L. Blackwell

Forest Protection Forms
Form #	Form Name	Last Revised	Owner
e223C	Vehicle Use & Costs Record		Protection
380.10	Burning Authorization Log	11/2007	Protection
	Repeater Hut Maintenance	12/2007	Protection
e505.1	Individual Fire Report	03/2005	Protection

Property Forms
Form #	Form Name	Last Revised	Owner
e810.2	Property Transfer Receipt	6/2007	Bob Ponder
810.2	Property Transfer Receipt	6/2007	Bob Ponder
e810.5	Property Certificate of Member Responsible for Occurrence	7/2007	Bob Ponder
810.5	Property Certificate of Member Responsible for Occurrence	7/2007	Bob Ponder
SEVO 7/08	Specialized Equipment - Virtual Office Log Form (BFM-DFA)	7/2008	Bob Ponder

Purchasing Department Forms
Form #	Form Name	Last Revised	Owner
e17.10.20	Mandatory E-Payment Exemption Request	4/2006	Purchasing
e17.10.20	Instructions for Form 17.10.20	4/2006	Purchasing
e17.20.5	Vendor File Maintenance Form	4/2006	Purchasing
e17.20.5	Instructions for Form 17.20.5	4/2006	Purchasing
e	Credit Card Log (For Individual Card Holder)	11/2008 12/9/09	Purchasing
e161.2	CitiBank Visa Cover Letter (For District Use Only)	10/2007	Purchasing
e164.3	Bill of Sale	5/2005	Purchasing
e164.4	Buyers Receipt	5/2005	Purchasing

Safety Forms
Form #	Form Name	Last Revised	Owner
	Tort Claim Requirements for Claimants	10/2008	John Walker
e	Liability Claim Reporting Form (Tort Claim) With Instructions	10/2008	John Walker
e	MWCC Workers' Compensation First Report of Injury or Illness	8/2001	John Walker
e188.1	Bi-Monthly Safety Meeting Report	7/2003	John Walker
e181.2	Personal Injury Accident Investigation Report	7/2007	John Walker
e181.4	Vehicle Accident Investigation Report	5/2006	John Walker
e181.5	Log & Summary of Occupational Injuries	7/2007	John Walker
e181.7	Return To Work Notice	7/2007	John Walker

Training Forms
e	Application for Reclassification for Ranger Series	7/26/2007	John Walker
e	Application for Reclassification for Technician Series	7/26/2007	John Walker
e	Application for Reclassification for Forester Series	02/03/2009	John Walker
e	NWCG Interagency Training Nomination and Agreement to Collect Funds		John Walker
e193.1	Training Form Report	6/2005	John Walker


Other Sources/Agency's Forms
eI-9	Employment Eligibility Verification	6/05/2007	11/3/2008
eW-4	Employee's Withholding Allowance Certificate 2009	2009
eW-9	Request for Taxpayer Identification Number and Certification	10/2007
e	Mississippi Employee's Withholding Exemption Certificate	2000
OFCCP 1420	Equal Employment Opportunity Is The Law Poster	8/2008	U. S. Dept. Of Labor
WHD 1088	Federal Minimum Wage Poster	6/2007	U. S. Dept. of Labor
	Military Family Leave Poster
WHD 1420	Family & Medical Leave Poster	1/2009	U. S. Dept. of Labor
AD-475C	And Justice For All Poster	9/2006
	Know Your Benefits - State and School Employees' Life and Health Plan	1/2007	DFA
	Life Insurance Group Coverage Plan		DFA
MSAPP 12/2008	State and School Employees' Life Insurance Plan Enrollment/Change Request Form	12/2008	DFA
EDF69659	Group Life Insurance Evidence of Insurability	12/2006	DFA
	Mississippi State Employee Handbook July 2007 Changes to July 2005 Handbook	7/2005 7/2007	SPB
eD00-200-GRP APP	AlwaysCare Employee Benefits Dental & Vision Insurance	7/2004
eFRM10-04	Election And Salary Reduction Agreement	10/2004	SABC
	Public Employees' Retirement System of Mississippi Handbook	1/2008	PERS
	Election Changes CHIPs	4/2009
	Article IV Benefits Elections CHIPs	4/2009
e	State of Mississippi State and School Employees' Life Insurance Plan Enrollment/Change Request Form	10/2005	Personnel
	State of Mississippi State and School Employee's Health Insurance Plan Application for Coverage	12/06	Personnel