Human Resources and Equal Opportunity

Below is an alphabetical listing of Human Resources and Equal Opportunity forms for you to either print up from the web or download to your desktop. All downloadable documents are for the PC only, Macintosh versions are no longer available. If you have any questions or need to request a form that is not here, or that you are having trouble printing up on your local printer, please use the email Anna or drop by the HREO Office in Craven Hall Room 1200. Please be sure to include the form's title, your name, and your department name within the email to ensure delivery within 48 hours.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Standard Forms
FORM	DESCRIPTION	PROVIDED BY
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Additional Employment Appointment Request Form	To request more than full time appointment for For Staff and MPP employees. See the Additional Employment and Overload Guidelines and Procedures for additional information. 1/2005	HREO
Additional Employment and Overload Guidelines and Procedures	Additional employment guidelines are designed to provide a framework within which employees may be appointed for more than full time, and establish the total amount of employment an individual may have with the California State University (CSU). 1/2005	HREO
Applicant Authorization and 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
ARF (Application Rating Form)	used by screening committees to rate applications	Recruitment
ARF Instructions	How to use the ARF (Application Rating Form). PDF format, use Acrobat Reader.	Recruitment
ATF (Academic Transaction Form)	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
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Benefits Worksheet	See Health Benefits worksheet below.
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CalPERS Beneficiary Designation Form	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
COBRA Dental Form	used to enroll in COBRA dental coverage This form is not available for download. Please request via email.	Benefits
COBRA Election Form	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
COBRA Health Form	used to enroll in COBRA health coverage This form is not available for download. Please request via email.	Benefits
COBRA Vision Form	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
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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
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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	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 Eval	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
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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	used 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
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Health Benefits Worksheet - (must be printed on pink paper)	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
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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
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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
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Lead Worker ID Form	used by departments to identify Lead Workers	Employee Relations
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Maternity / Paternity / Adoption Paid Leave Application	used by individuals to request paid leave for Maternity, Paternity or Adoption	Benefits
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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 Personnel 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
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Recruitment Procedure Checklists With Committee Without Committee	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
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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
Special Consultant Form revised 5/25/05	used to create or make changes to a Special Consultant's appointment	HREO
Special Consultant Time Sheet	used to document a Special Consultant/ time worked.	Payroll
Staff Handbook (coming soon)	used as a basic guideline for staff employment	Employee Relations
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 Employment Handbook	Used as a basic guideline for student assistant employment	Employee Relations
Student Assistant Payroll Action Request (SPAR) (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 Plus/Minus 2008 Calendar	Plus/Minus Calculator: May 26, 2008 - August 15, 2008 schedule Plus/Minus Calculator: June 2, 2008 - August 22, 2008 schedule	HREO
Summer 9/80 Work Schedule Request Form	2008 9/80 Summer Work Schedule Request Form - Non-Exempt Employees 2008 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
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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
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UC Benefits Retirement Forms	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 Page 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.
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Veteran Self-Identification form	Used to self identify Veteran status. Statistical reporting required by Vietnam Era Veterans Readjustment Assistance Act of 1974 (VEVRAA), but submission is voluntary	HREO
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
Voluntary Child Support Form	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
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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

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Human Resources and Equal Opportunity

Cal State San Marcos
333 S. Twin Oaks Valley Rd
San Marcos, CA 92096-0001