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

Benefits

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

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.

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.

Payroll

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 Forms

Please refer to the Performance Evaluation Forms webpage.

HREO

Employee Reference Check Authorization and Release

Authorization form for CSUSM employees to provide information concerning your employment at CSUSM.

Recruitment

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.

Benefits

Benefits

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

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 In-Range Progression Review form and 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)

Used to create official description of a staff position. It describes the purpose, duties, responsibilities and requirements of the position. Please use Guidelines for Job Description Form 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

MPP Performance Evaluation Forms

Please refer to the Performance Evaluation Forms webpage.

HREO

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

Performance Evaluation Forms

Please refer to the Performance Evaluation Forms webpage.

HREO

Personnel Action Notice form (Printed on PINK PAPER ONLY)

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

Recruitment

Personnel Action Notice Guidelines

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  

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 request appointment for Special Consultant. The form also includes a definition/description of a special consultant, hiring and approval process, and roles and responsibilities of the various levels of the appointment.

Special Consultant Timesheet

Used to document a Special Consultant/  time worked.

Payroll

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

2012 9/80 Summer Work Schedule Request Form - Exempt Employees

2012 9/80 Summer Work Schedule Request Form - Non-Exempt Employees

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

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

W-4 Form

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

HREO