Forms

Absence Slip - An employee uses this form to report use of vacation, sick leave, leave without pay, and compensatory time off.

Academic Student Employee Letter - An academic department uses this template as required by Article 2 of the UC/UAW (ASE) Agreement. Modifications must be approved by Employee & Labor Relations prior to issuance to the potential employee.

Access Violation Report - A department uses this form to report unauthorized or illegal activities by employee organizations. See P&P 380-21 for further information.

Benefits Forms - This link will take you to the Benefits forms page, which includes insurance enrollment and COBRA notification forms, among others.

University of California State Oath of Allegiance Agreement form

Catastrophic Leave Sharing Program - This program allows an employee to donate accrued vacation to support a colleague who has exhausted his or her paid leave due to a catastrophic illness. Departments are responsible for telling an employee about this program if it is likely that he or she could be an eligible recipient.

Child Abuse Notification - A department uses this form when a new employee is hired in a position designated as a "mandated reporter" under the California Child Abuse and Neglect Reporting Act and UCD Policy & Procedure Manual Section 380-81.

Compensatory Time Off Election - The PPSM Compensatory Time Notification form is used to document the employee's agreement that the department can choose whether to compensate premium overtime with pay or compensatory time off. The CX, SX, F3, TX, RX or HX Compensatory Time Agreement form is used to document the employee's annual agreement on a method of compensation.

Contract Appointments - A contract appointment is an appointment established at a fixed or variable percentage of time for a definite period. Terms and conditions of employment are specified in a written employment contract. See PPSM UCD Procedure 3 for procedures.

DMS Forms - Disability Management Services(DMS) Forms include: Temporary Accommodation; Reasonable Accommodation Record of Action and Medical Separation.

Elder Abuse Notification - Employees who are likely to provide health or social services to elders or dependent adults must sign a statement that they are aware of the law and will comply with its provisions.

Emergency Information - A department uses this form to give an employee an opportunity to provide information that may be useful should there be a medical or other emergency at work.

Employee Development Worksheet - A supervisor uses this form for evaluations that are not part of the annual performance appraisal process (e.g. for probationary or limited employees, or regular status employees at a time other than the annual review). The forms should be retained by the department.

License or Certification Requirements and Verification - The department must verify the applicants license upon hire, promotion, transfer, or reclassification if it is required for the job by law.  Contact your Employment Consultant/Recruiter for more information. 

Near Relatives Request - For more information about the use of these documents please contact your Employment Consultant/Recruiter or your Employee and Labor Relations Consultant

Notice of Intent to Change Terms & Conditions of Employment - Departments cannot take unilateral action to change established terms & conditions of employment (e.g., work rules, such as dress code or time keeping system) without providing notice to the unions through Employee & Labor Relations.  Please refer to specific contract for notice timelines.

A department uses this form to ask Human Resources to provide notice to a union of a proposed change in the terms and conditions of employment.

Partial Year Career Certification - A department uses this form to notify an employee at the time of hire that there will be annual furlough periods.

Partial Year Furlough Notice - A department uses this form to notify an employee at the beginning of each furlough period.

Probationary Period Report - A department uses this form to report the results of the probationary evaluation, extend the probationary period, end employment of probationary employees, or certify the attainment of career status.  Please refer to the relevant contract or policy section on probationary status for specific information about timelines and evaluation requirements.

Staff Leave Request Form

Vacation Plan Worksheet - An employee and supervisor use this form when the employee is at or near the maximum vacation accrual.

Verification of Previous Employment - This form is to be used for employees who have employment service credit with another UC, DOE (Department of Energy) Lab, or State of California service. 

Directions:  The employee should complete the form with all relevant information, print & sign, and then mail it to their former employer.  The section in yellow is to be completed by the employee - please fill in the mailing address of your current department's payroll processor.  Your former employer will then mail the completed form directly to them.

Volunteer Information Record (Form) - This form is used to obtain demographic information from volunteers and volunteer activity information from departments. The form should be completed by all non-employee volunteers. The purpose of the information is to determine eligibility for possible workers compensation benefits in the event that the individual is injured while providing volunteer services to the University.