HR Forms & Procedures
Benefits
- eBenefits Self-Service Authorization form
Employee authorization form to enroll or modify benefits enrollment. - Benefits - CalPERS Affidavit of Marriage
Allows certification of marriage when no marriage certificate is available. - Benny Card Application
Flexible Spending Plan Debit Card Request Form - Blue Shield Access + (HMO) and Net Value (HMO): Selecting Primary Care Physician
Form needs to be mailed to Blue Shield (HMO) with current or newly selected Blue Shield (HMO) physician(s) and medical group(s). - Blue Shield Access+ and Net Value: Changing Primary Care Physician
Step-by-Step guide on how to change primary care physician. - CalPERS Beneficiary form
- Catastrophic Leave Donation Request and Certification Form
Employee request for participation. - Delta Dental Claim Form
For employees to be able to submit dental claims. - Domestic Partnership Imputed Tax Notice
- Domestic Partnership Imputed Tax Notice - Economically Dependent Child Affidavit
- FML - Family and Medical Leave Act
Summary of the Family and Medical Leave Act program. - FML - Family and Medical Leave Notice and Request Form
To process employee request for family medical leave. - Leave of Absence Guide
Guide describing leaves of absence. - Leave of Absence Request
To request a leave of absence. - Life - Employer Paid Life Certificate 2005
Certificate for group life insurance. - LTD - Employer Paid Certificate 2005
Certificate for group long term disability insurance. - Return-to-Work
- Employee Information Sheet
Forms to be completed by supervisor for work related
or non-work related transitional work due to work restrictions. - The Standard Life Insurance
Beneficiary form - TSA - 2011 Automated Tax Sheltered Annuity 15 year Catch-up Calculation Worksheet
To demonstrate eligibility for 15 year catch up contributions for TSA 403(b). - TSA - Tax Sheltered Annuity Companies
List of TSA (403b) plans. - Vision - Out-of-Network Reimbursement Form
To claim vision services with an out-of-network provider. - Vision - Video Display Terminal (VDT) Claim Form
To claim VDT glasses.
Classification & Compenstation Forms
- Position Description Form
To describe positions submitted for classification reviews.
- In-Range Salary Progression Guidelines
To request a permanent increase to a base salary within a salary range for a single classification.
- Request for Reclassification Review
To request reviewing of a position and determining an appropriate CSU classification for all staff (non-faculty) positions.
Employment
Perfomance Review Forms
- Employee Self Appraisal Form
For employee to fill in prior to evaluation.
- Performance Review Guide
PowerPoint slides
- Staff Performance Review Form
To evaluate staff employees' performance (except Unit 3 and 4).
- Unit 4 Staff Performance Review Form
To evaluate Unit 4 employees' performance.
Personnel Services
- Separating Employee Clearance Form
To process the resignation or retirement of employee.
- Volunteer Appointment Form
To appoint and process CSUEB volunteers.
Recruitment Forms
- New Employee Checklist
- Department Checklist
- Reference Check Form
- CSUEB MPP Screening Grid
- MPP Interview Questions
- MPP Position & Salary Request
- Template - Application Screening Grid
To log scores during application screening (one per each selection committee member) - Template - Application Screening Summary
To total all scores of application screening - Template - Interview Rating Sheet
To note candidates answers and scores during interview - Template - Interview Results Summary
To log and total interview scores.
