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Aetna Enrollment Form
Dental Change Form
Dental Enrollment Form
FSA Enrollment Form
Health Waiver Form
Met Life Supplemental Enrollment Form
Met Life Beneficiary Form
Tennessee Consolidated Retirement System (TCRS) Change of Beneficiary Form
Tennessee Consolidated Retirement System (TCRS) Application For Additional Retirement Credit Form

Due Process Notification Form
EEOC Complaint Form
Employee Corrective Action Form
Employee Grievance Form
Harassment Mediation Resolution Form
Intake Interview Form (Workplace Harassment)

Employment and Selection
City of Clarksville Employment Application
Consolidated Interview Score sheet
Employee Orientation Checklist
Essential Function and Job Analysis Form
Exit Questionnaire Form
Interview Documentation Form
Interview Evaluation Form
Job Description and Evaluation Request
Job Description Worksheet
Notice of Secondary Employment
Reference Check Form
Request for Job Change (“Blue Form”)

Family Medical Leave Act (FMLA)
Family and Medical Leave Notification
Family and Medical Leave Return to Work Medical Certification Form
FMLA Employee Leave Request
FMLA Employer Designation Letter
FMLA Physician Certification of Health Care Provider for Employee
FMLA Physician Certification of Health Care Provider for Family Member
FMLA Return to Work Certification Form
Request for Family and Medical Leave

Expiration of Leave Without Pay Notification
Leave of Absence Request Form
Sick Leave Transfer Authorization
Sick Leave Transfer Request

Address Change Form
Application for On-Duty Handgun/Fire Helmet
Change of Status Form
Compensatory Time in Lieu of Overtime Request Form
Confined Space Checklist
Daily Excavation Checklist
Departmental Policy Statement for Overtime Occurring on a Regular Basis
Ethics Policy Acknowledgement
Hold Harmless Agreement (Handgun/Fire Helmet)
Identification Card Agreement
Overtime Approval Form
Performance Evaluation
Position Justification Form
Reasonable Accommodation Process Checklist
Workplace Violence Risk Assessment Checklist

Authorization to Make Deductions from Wages
Direct Deposit Form (change)
Direct Deposit Form (start)
Direct Deposit Form (stop)
Generic – Add/Delete Form
Pay Table - Fire
Pay Table - General
Pay Table - Police
W-4 (2012)

Risk Management
General Liability Claim Form
Motor Vehicle Accident Report Form
On-the-Job Injury (OJ) Form


The City of Clarksville is an Equal Opportunity Employer
Last updated: 8/1/2014 2:07:10 PM