Forms

UARSC FORMS

Benefits Information and Forms
Benefits Summary
Benefits for Cash Plan
Cafeteria Plan Benefit Summary- Flexible Spending Accounts (PDF)
Cafeteria Plan - Claim Form (Dep. Care & Healthcare Expenses) (PDF)
Cafeteria Plan - Direct Deposit Authorization Form (PDF)
Cafeteria Plan - Enrollment Form (PDF)
Cafeteria Plan - Flexible Spending Account Instructions (DOC)
Cafeteria Plan - IRS Revenue Ruling 03-102 (PDF)
Cafeteria Plan - IRS Publication 502 - allowable expenses (PDF)
Cafeteria Plan - Presentation (PPT)
Cafeteria Plan - Summary of Material Modications (DOC)
Career Development Educational Reimbursement Program
COBRA Notice (PDF)
Dental Benefit Summary (Delta Dental) (PDF)
Employer-Paid Payroll Taxes and Benefits
Long-term Care
Vision Insurance - Summary Plan Description (PDF)

Financial & Accounting Forms
AccountList
Check RequesT (DOC)
Computer Service Agreement (UARSC) (DOC)
Deposit/Transmittal (Checks and Cash) (XLS)
Deposit Transmittal (Credit Card Vouchers) (XLS)
Inventory Tag & Status Form (XLS)
Petty Cash Request (XLS)
Project Agreement - Campus Activities (XLS)
Purchase Order - Regular (XLS)
Purchase Order Amendment (XLS)
Transfer Request (XLS)
Travel Expense Claim (XLS)
Travel Request Form and Travel Allowance Guidelines (XLS)
Travel Request and Claim Tips (DOC)

Human Resources Forms
Application for Employment (Non-Student)
Application for Employment (Student)
Application Rating Form
Change of Address/Name
Employment Authorization Form - Standard (for most employees)
Employment Authorization Form - Faculty/Exempt Level CSU Staff (use for CSUSM employees ONLY)
Employment Requisition (pre-approval form when wanting to hire regular, benefited UARSC employees)
Guest Lecturer Form
I-9 Form (Employment Eligibility)
I-9 Guidelines (Documents Required at New Employee Orientation)
Independent Contractor Packet
Interview Rating Form
Job Description (Non-Student Assistant)
Job Description (Student Assistant)
Performance: Employee Self Evaluation
Performance: Performance Appraisal (for more information, refer to Performance Appraisal Policy)
Performance: 90-Day Form #1 (Optional)
Performance: 90-Day Form #2 (Optional)
Reference Check (Non-Exempt)
Reference Check (Exempt Positions)
Reimbursed Time Form
Release of Liability
Report of Injury or Illness
Salary Reduction Agreement - Regular Employees (Retirement Plan)
Salary Reduction Agreement - Temporary Employees (Retirement Plan)
Self Evaluation Form
Separation Notice
Volunteer Application
W-9 Form

Payroll Forms
ADP iPayStatements - Registration Instructions (PDF)
DE 4 California Withholding Allowance Certificate (PDF)
Direct Deposit - Payroll Distribution Form (DOC)
Holiday Schedule 2013 (PDF)
Payroll Schedule 2013 (PDF)
Time Sheet (Non-Student Assistants) (XLS)
Time Sheet (Student Assistants) (XLS)
W-4 Form 2013 (PDF)

Risk Management Forms
Catering and Food Service Vendors Insurance Requirements (PDF)
Automobile Insurance Certification (DOC)
Food Safety Checklist (DOC)
Indemnification and Hold Harmless (PDF)
Release of Liability (PDF)
Transportation Providers Insurance Requirements (PDF)
Worker's Compensation Declaration (PDF)

Sponsored Projects Forms
Sponsored Projects Approval Form (SPAF) (DOC)
Conflict of Interest Disclosure Form (Governmental: DHHS/PHS/NIH) (DOC)
Conflict of Interest Disclosure Form (Governmental: Non-DHHS/PHS/NIH) (DOC)
Conflict of Interest Disclosure Form (Non-Governmental Funding Source) (DOC)
Conflict of Interest - PHS & NIH Principal Investigator Certification (PDF)
Cost Sharing Approval/Verification Form (DOC)
Funding Search Request Online Form
Project Agreement-Campus Activities (formerly Project Agmt-GPSM) (XLS)
Project Agreement-Sponsored Projects (XLS)