HR Forms:

Applicant Authorization Release Form

used by applicants to authorize CSUSM to conduct reference and employment background  checks - this is an Adobe Acrobat document - you will need Adobe Reader to view the document.

Recruitment

used to create or make changes to a Faculty employee's appointment  This form is not available for download.  Please request via email.

Academic Resources

See Health Benefits Worksheet below.

used to identify a PERS employee's beneficiary                  
This form is a triplicate form and not available for download.  Please request via email.

Benefits

CalPERS Separation Form

used when a PERS employee leaves the University - to indicate what he/she would like done with his/her PERS contributions.  This form is a triplicate form and not available for download.  Please request via email.

Benefits

CalPERS Service Retirement Form

used by CalPERS employees to apply for service retirement.  This form is not available for download. Please request via email

Benefits

CalPERS Retirement Calculator

a link to the CalPERS retirement estimation program site.

Payroll/Benefits

Catastrophic Leave Donation Form (MSWord doc)

used to donate vacation or sick accruals to employees in need of extra sick time due to a catastrophic event

Payroll/ Benefits

used to enroll in COBRA dental coverage
This form is not available for download.  Please request via email.

Benefits 

used to designate if employee would like benefits to continue, when he/she is no longer eligible for benefits coverage (separation, dependent turns 23, etc.) Not available for download. Please request via email.

Benefits

used to enroll in COBRA health coverage
This form is not available for download.  Please request via email.

Benefits

used to enroll in COBRA Vision coverage
This form is not available for download.  Please request via email.

Benefits

Confidentiality of Employee, Student and Faculty Data Statement (for staff)

Confidentiality of Employee, Faculty and Student Data Document to ensure that the employee understands the state and federal laws and university policies that govern access to and use of information contained in the employee, applicants, and student records, including data that is accessible through any university human resource information system. To be signed by Manager and Employee.

HREO

Dental Enrollment Form (STD 692)

once signed by the employee, HR uses this form to enroll  the employee for dental coverage.

Benefits 

Dependent Care Reimbursement Enrollment Form

Used to enroll in Dependent Care Reimbursement Program PDF format

Benefits

Dependent Care Reimbursement Claim Form (ASI)

Used by employee to claim reimbursements under the  DCRA program.

Benefits

Direct Deposit Form
(STD 699)

used to enroll in or make changes to the direct deposit of an employee's pay warrant. Link to Payroll Forms Page.

Payroll

Duplicate W-2 Request Form

used to request a duplicate copy of an employee's W-2 form.  Cost is $8.50 to the employee. This is a State of California form and is available for download .

State Controller's Office

Employee Action Request Form (EAR)

multiple purpose form to be used for one of the following for a staff, faculty or administration member:  sign in an employee, change of address, change of tax withholdings, change of name, or change of birth date. This form is a triplicate form; if you download it, you must submit 3 copies. Or, request a 3-part NCR form from HREO
Note: Change of address can now be made directly through the portal at my.csusm.edu

HREO 

Employee Performance Evaluation Form

Forms used by managers to evaluate employee performance during probation and annually thereafter.

HREO

Employee Reference Check Authorization and Release

authorization form for CSUSM employees to provide information concerning your employment at CSUSM

Recruitment

CSUEU Employee Rating Form R0/Units 2, 5,7 & 9 (New 2008)

New form used by a supervisor to evaluate a Staff Employees in Units 2,5,7 & 9, Students may not be evaluated using this form

Employee Relations

Staff Evaluation Forms R0/Units 1,6, 8 & Confidential Employees

Form used by a supervisor to evaluate a Staff Employees in Units 1,6,8 & Confidential Employees

Employee Relations

Unit 4 (R04) Staff Evaluation Forms

Form used by a supervisor to evaluate a Staff Employee in Unit 4

Employee Relations

SUPA Unit 8 Staff Evaluation Form

Form used by a supervisor to evaluate Staff Employee in Unit 8

Employee Relations

SUPA Unit 8 Staff Evaluation Continuation Form

Form used by a supervisor to evaluate Staff Employee in Unit 8

Employee Relations

Evaluation Form - MPP

MPP Performance Evaluation Program and Forms

Employee Relations

Evaluation Form - Self Evaluation

used by an employee when he/she is evaluated by his/her supervisor-  To be used in conjunction with the Staff Evaluation Form.

Employee Relations

Fee Waiver - Admission Reduction Eligibility Form

used by employees to attach to the CSU Application form in lieu of payment.  Contact HREO at x4419 for more information.

Benefits / Training

Fee Waiver - Staff Application

use to enroll in the Fee Waiver Program

Benefits / Training

Fee Waiver - Work Related Registration Form

used to register in work related classes

Benefits / Training

Fee Waiver - Career Development Form

used in conjunction with the Fee Waiver Application when the classes enrolled in are used for Career Development

Benefits  /Training

Fee Waiver - Dependent Form

Used when Staff member wishes to transfer his/her Fee Waiver Benefit to a dependent.

Benefits  /Training

FlexCash Enrollment Authorization

Used when staff member wishes to receive cash reimbursement in lieu of Health benefits. Complete Sections 1 through 6 only, print hard copy, turn in to HREO with original signature.

Benefits

used by an employee to inform HR of which Benefits choices he/she has made.

Benefits

Health Care/Dependent Care Reimbursement Enrollment Form

Used by employee to enroll in Health Care Reimbursement Program PDF format

Benefits

Health Care Reimbursement Claim Form (ASI)

Used by employee to claim reimbursements under the HCRA program.

HRIS Access and Compliance Form
(For Faculty)

Form used to certify that faculty member has received training on the appended state and federal laws and University policies that govern access to and use of information contained in employee, applicant, and student records, including data that is accessible through the PeopleSoft Human Resource System.

CSU Labor Relations

Form I-9, Employment Eligibility Verification

a listing of acceptable identification to use when an employee (of any type) is hired.

HREO

In-Range Progression Review Form (Revised 2/2008)

In-Range Progression requests are submitted by the appropriate administrator for the department involved. See the Guidelines for requesting an In-Range progression.

HREO

In-Range Progression Request Guidelines

Instructions for using the form and details of Bargaining Unit requirements.

HREO

IRF (Interview Rating Form)

used by interview committees to rate interview candidates. See instructions for use below.

Recruitment

IRF Instructions

How to use the IRF (Interview Rating Form). PDF format, use Acrobat Reader.

Recruitment

 Job Description Form

(Staff)
MS Word Doc. Download file to your desktop. Open the form in MSWord. Insert text. Save completed form. Revised 9/1/04

Guidelines for Job Description Form (MS Word Doc)

Used to create official description of a staff position. It describes the purpose, duties, responsibilities and requirements of the position.

Guidelines for completing the Staff Job Description Form

Recruitment

Lead Worker ID Form

used by departments to identify Lead Workers

Employee Relations

Maternity/ Paternity/ Adoption Paid Leave Application

used by individuals to request paid leave for Maternity, Paternity or Adoption

Benefits

Pay Warrant Calculator - 2006

Use this downloadable excel spreadsheet to see what your pay warrant will be after taxes.  This form allows you to modify your withholdings and TSA amounts before you actually make the change through payroll.

Payroll

 Personnel Action Notice form (Printed on PINK PAPER ONLY)
Revised 12/14/04

Used to create or make changes to a Staff or Student employee's appointment. Available for download.

Recruitment

Personnel Action Notice Guidelines
Revised 4/23/08

Instructions for completing the PAN form. Available for download.

Recruitment

Personnel Information Sheet (to be printed on blue paper only)

multi-use form used by staff, faculty, and management employees when they are hired, need to change their emergency contact, or, designate someone to receive final pay warrants.
This form is not currently available for download.  Please request via email. 

Payroll

Personnel Requisition
(to be printed on grey paper only)

used by a department to initiate the search for a new or replacement employee.  This form to be printed on grey paper only.

Recruitment  

Not currently required pursuant to President's memo   dated 5/11/05
President's Approval Action Form
to be printed on yellow paper

This form must be completed and signed by the President  prior to any processing of certain personnel transactions by Human Resources and Equal Opportunity (HREO). Pursuant to President's memo dated November 19, 2004.

Recruitment

PST Retirement Benefit Reimbursement Form

used when a Part-Time Seasonal and/or Temporary employee leaves the University - to request refund of PST contributions. Click on link to www.sppforu.com and look for Plan Info and Forms

Benefits 

PST Beneficiary Change Form

used to identify a Part-Time Seasonal & Temporary employee's beneficiary
Click on link to www.sppforu.com and look for Plan Info and Forms

Benefits 

the checklist/guidelines used by search committees to fill available positions

Employee Relations

Reference Check Guidelines

If you are serving on a search committee this will help you understand the reference check process.

Employee Relations

Report Request Form

Use when requesting ad hoc reports from Human Resources and Equal Opportunity.

HREO

Retirement Estimation Program

a link to the CalPERS site

Payroll/Benefits

Savings Bonds Purchasing Form

used to enroll in the Savings Bond purchase program.

This form is not available for download.  Please request via email.

Payroll

 Signature Authorization  - Attendance Reporting (Payroll)

used to authorize which employee is authorized to report attendance for each department

Payroll

Signature Authorization - Overtime Approval (Payroll)

used to authorize which employee is allowed to authorize over-time for each department

Payroll

Signature Authorization - Pay Warrant Pick-Up (Payroll)

used to authorize which employee is authorized to pick up Master and Intermittent  Pay Warrants  for each department

Payroll

used to create or make changes to a Special Consultant's  appointment

HREO

Special Consultant Timesheet

used to document a Special Consultant/  time worked.

Payroll

Student Employee Emergency Contact Form

Turned in to HREO upon employment and kept in employee's personnel file. This form  identifies emergency contact information and personal data information

Recruitment

Student Employment Information Sheet

Hiring department (HD) provides this checklist to all student employees to bring with them to Human Resources Office when they are hired.  The checklist outlines what will be required at the time they sign-in with HREO;  HD should also note correct job code/title on the top of the form which will assist in signing the new student on to the payroll system. For more information see the Student Employee Hiring Process guide

HREO

Student Assistant Payroll Action Request (STD457)

Multiple-use form to be used for one of the following for a student employee:  hire, change address, change tax withholdings, change  name, or correct birth date. 

You may download the form from the Payroll Services website (provide two signed copies to Payroll) -or- request the  triplicate form via email.

Payroll

Summer 9/80 Work Schedule Request Form

2009 9/80 Summer Work Schedule Request Form - Non-Exempt Employees

2009 9/80 Summer Work Schedule Request Form - Exempt Employees

HREO

Summer Bridge - Student Employee Emergency Contact Form

used to identify the person to contact in case of an emergency with regard to summer bridge students

HREO

Telecommuting Agreement Form

The Telecommuting program at California State University San Marcos is designed to provide flexibility in work options. See the University Policies and Procedures for more information.

HREO

Time Sheet - Student Employee

used to identify the hours worked by a Student Assistant (regular student assistant, federal work-study, or bridge student assistant)

Payroll

TSA (403b) Certificate of Account

used to certify the existence of an employee's TSA(403b)  account

Benefits 

TSA (403b) Salary Reduction Form
(updated 02/06/08)

used to enroll in the TSA (403b) program and/or change an employee's TSA(403b)  deduction.

Benefits

used when a UC Contribution Plan employee leaves the University - to request reimbursement or roll over of UC Contribution Plan contributions  
** note ** this does not refer to work done at the UC system - it is a type of plan used here at CSUSM for certain types of temporary employment.
This form is not available for download.  Please request via email.

Benefits 

Useful Numbers & Web Links

a list of 1-800 numbers and web links to various health, dental, vision, retirement, and credit union vendors that we use on campus. 

Payroll/Benefits/
Retirement/misc.

Vision Video Display Terminal Form (VDT Form)

Claim form to take to vision care provider. Used solely by the employee when he/she qualifies for Video Display Terminal (VDT) benefits. Employee (or patient, if not employee) must take this form to eye appointment.

Benefits 

used by an employee to set up automatic deduction for Child Support payments from his/her pay warrants
This form is not available for download.  Please request via email.

Payroll

Volunteer Employment Form

completed when someone from the community would like to volunteer his/her time at the University
This form is in PDF format for use with Adobe Acrobat Reader.

HREO

Workshop Registration Form

used to register for Human Resources trainings and workshops

HREO

W-2 Request Form

used to request a duplicate copy of an employee's W-2 form.  Cost is $8.50 to the employee. This is a State of California form and is available for download .

State Controller's Office

W-4 Form

See the Employee Action Report (EAR) form above to change Tax withholding information

HREO