Sarpy County

If your position is covered by a Union, please review your Collective Bargaining Agreement for specifics.

Employment Forms

Appeal Form - Classified Employee
Background Check Release Form
Compensatory Time Off Tracking Form
Employee Action Form (for Employment Information, Change of Personal Information, Budget, etc.)
Exit Interview Questionnaire
Grievance Form - Classified Employee
Letter of Resignation Form
Notice of Retirement Form
Secondary Employment Request Form - Classified Employee
Separation of Service Packet (Effective 01/01/2016)

Department Head Forms

New Job Creation Request Form
Personnel Requisition Form - Classified Position (Revised September 2016)
Personnel Requisition Form - UNCLASSIFIED (Revised November 2017)
Performance Evaluation Form - Introductory/Probationary
Performance Evaluation Form - Annual
Discipline - Classified Employee
Discipline - Unclassified Employee


Insurance & Safety Forms

Employee Insurance: Change Request Form
C.D.L. Notification of Traffic Violation   
Workers' Compensation: First Report of Alleged Occupational Injury/Illness Report - (Contact Human Resources for filing instructions and Provider Forms)
Supervisor's Report
Liability Form: contact your department for specifics

Miscellaneous Forms

Educational Reimbursement Application Form - Classified Employee
Educational Reimbursement Application Form - Unclassified Employee
General Complaint Form
Key Card Request Form -- contact HR
Whistleblower Form -- contact HR

Let us help you with any of your questions regarding Sarpy County Human Resources.

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