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Benefits Information & Forms
Human Resources Forms
Financial & Accounting Forms
Payroll Forms
Risk Management Forms
Sponsored Projects Forms
Who to Contact

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
Billing Upload (XLS)
Deposit Form
Direct Pay Form (DOC)
Direct Deposit Authorization Form
Direct Deposit Informational Flyer
Computer Service Agreement (UARSC) (DOC)
Expenditure Transfer (XLS)
Inventory Tag & Status Form (XLS)
Payee Data Record Form 204 (PDF)
Petty Cash Voucher (PDF)
Project Agreement - Campus Activities (also includes Project Agmt-GPSM)
Purchase Order Amendment
Student Air Travel Acknowledgment of Risk and Release of Liability (PDF)
Travel Expense Claim (XLS)
Travel Helpful Hints (PDF)
Travel Request Form and Travel Allowance Guidelines (XLS)

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
Release of Liability
Reimbursed Time Form
Report of Injury or Illness
TIAA-CREF Salary Reduction Agreement - Regular Employees (Retirement Plan)
TIAA-CREF Salary Reduction Agreement - Temporary Employees (Retirement Plan)
Self Evaluation Form
Separation Notice
Volunteer Application

Payroll Forms
ADP iPayStatements - Registration Instructions (PDF)
DE 4 California Withholding Allowance Certificate (PDF)
Direct Deposit - Payroll Distribution Form (DOC)
Holiday Schedule 2015 (PDF)
Payroll Schedule 2015 (PDF)
Time Sheet (Non-Student Assistants) (XLS)
Time Sheet (Student Assistants) (XLS)
W-4 Form 2015 (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
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
Purchase Order Amendment
Sponsored Projects Approval Form (SPAF)
Sponsored Projects Requisition Form (XLS)