Forms for City Employees

***Please Note***
Downloading documents from this site could take a couple of minutes. For best results save documents when prompted.

• Address Change Form (PDF)
• Annual Preventive Care Exam Form (PDF)
• Catastrophic Leave Bank
  • Catastrophic Leave Bank Program (PDF)
  • Catastrophic Leave Bank Enrollment Form (PDF) 
• Classification
  
  • Classification Review Request (PDF)
  • Frequently Asked Questions (PDF)
  • Position Analysis Questionnaire - New Positions (PDF)
• Direct Deposit Form (PDF)
• Disciplinary Action Appeal Hearing Process
  • Procedure Manual (PDF)
  • Request Form (PDF)
• Employee Notification System (PDF)
• Employee Recognition
  
  • Employee Recognition Program (PDF)
  • Employee of the Year Nomination Form (WORD)
• Employee Suggestion Form (PDF)
• Electronic Communication Policy (PDF)
• Grievance Form (PDF) 
• Independent Contractor
  • Employee vs. Independent Contractor Procedure Guideline (PDF)
  • Independent Contractor Determination Form (WORD)
• Jim Dailey Fitness Center Voluntary Deduction Form (PDF)
• Leave Request Forms
  • Paid Time Off (PTO) Leave Request Form (PDF)
  • Short-Term Disability (STD) Leave Request Form (PDF)
• Overtime Pre-Approval Form (PDF)
• Performance Feedback Appeal Form (PDF)
• Religious Reasonable Accommodation Request Form (PDF)
• Residency Incentive Program Application (PDF)
• Supervisory Equivalent Training (SET) Program Completion List (PDF) (EXCEL) 
• Termination Guidelines (PDF)
  
  • Non-uniform Defined Benefit Retirement Application (DOC)
  • Continuation of Benefits Coverage Form (DOC)
  • Non-uniform Defined Benefit Distribution Form (DOC)
• Time Sheet (EXCEL)
• Tuition Aid Application (PDF)
• Vendor Request Form (ONLINE)
• W-2 Reprint Request (PDF)
• City of Little Rock Web-Mail (PDF)

Forms for Supervisors

• Disciplinary Action Forms
  • Demotion Form (PDF)
  • Oral Reprimand Form (PDF)
  • Pre-Termination Hearing Notice (PDF)
  • Suspension Form (PDF)
  • Termination Form (PDF)
  • Written Reprimand Form (PDF)
• Drug Testing Forms
  • Baptist Health Authorization Form (PDF)
  • Information and Consent Form (PDF)
  • Reasonable Suspicion Documentation Form (PDF)
  • Reasonable Suspicion Training List (EXCEL)
• Employee Assistance Program (EAP) Mandated Referral Form (PDF)
• FLSA Questionnaire for Non-Exempt Employees (PDF)
• Performance Evaluation Forms
  
  • Probationary Employee (PDF)  
  • Employee Series (PDF)
  • Employee Series + Planning and Organizing (PDF)
  • Leader Series (PDF)
  • Supervisor Series (PDF)
  • Manager Series (PDF)
  • Evaluation Appeal Form (PDF)
• Status Change/Request Form (PDF)
• Termination Guidelines for Supervisors (PDF)
  • Resignation Letter (PDF)
  • Termination Clearance Form (PDF)
  • Unemployment Benefit Notice (PDF)
• Vehicle Out of Town Request (PDF)
• Violence in the Workplace Incident Form (PDF)
• Workers' Compensation Forms
  
  • Authorized Medical Facilities for Work Related Injuries (PDF)
  • Form AR-N - Employee's Notice of Injury (please print double sided) (PDF)
  • Modified Duty Form (PDF) 
  • Supervisor's Accident Report (PDF)