Human Resources, University of California, Berkeley

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UC Berkeley Human Resources Forms

The forms on this page are provided in Microsoft Word (.doc) and/or Portable Document Format (.pdf). PDF files can be viewed by using the Adobe Acrobat Reader, which is available free from the Adobe site. If you are using a screen reader to read material on this website, Adobe can convert PDF files to html. Some of the forms are accompanied by "How-To" files with instructions about how to use the form; others have instructions printed on the form. Forms from the Payroll Office, including Direct Deposit, are available on the Payroll website at http://financialoperations.berkeley.edu/Forms/FormsIndex.htm.

Title/Description of Form

Format(s)

How-To

Benefits: BELI Form (Benefits Eligibility Level Indicator )

Benefits: Request to Continue/Cancel Coverage

On the form

Benefits: Forms and Publications:
Resources for Departments

CALS Project Monthly Tutoring Report

CALS Project Survey for Supervisors

Classification Request Form

Compensatory Time Off Election Form for Clerical Unit Employees

Compensatory Time Off Election Form for PPSM Employees

Criminal Background Check: Sample letters

Demographic Data Transmittal Form
(formerly Affirmative Action Data Form)

Direct Deposit Form (UPAY 544A-1) Note: On the page linked at right, this form is officially called "Payroll Earnings Distribution Authorization" form.

Employee Organization Membership Payroll Deduction Authorization Form (UPAY 669)

Family and Medical Leave of Absence Request

Family and Medical Leave Certification Form

Family and Medical Leave - Return to Work Certification

Family and Medical Leaves (FMLA/CFRA/PDL) – Departmental Worksheet

Family and Medical Leave Benefits Checklist

Required Forms Checklist-Hire and Rehire

On the form

I-9 (Employment Eligibility Verification Form)

Interview Data Form (IDF)

On the form

Job Description Template (including an Addendum for Information Technology Positions)

Layoff: Sample Letters

Leave Time Report Form

Oath of Allegiance/Patent Agreement

Payroll Earnings Distribution Authorization (Direct Deposit)

Performance Evaluation and Planning (PEP) forms for the 2008 Evaluation Cycle (non-represented staff)

Performance Evaluation Forms for represented staff (sample forms)

Personal Data Form

Physical, Environmental, and
Mental Demands (PEM)

PPSM Grievance Form

Proof of Service Sample Forms:	Delivery by U.S. Mail
	Personal Delivery

Retirement Gift Request Form

Retirement Plan Waiver and Release

Service Award Request Form

SRA Evaluation Form

UCRS 419 Position not covered by Social Security

UAW Grievance Form

UAW Membership Form

W-4 Federal Withholding (Form UC W-4/DE 4) - This form can be filled in electronically. Read notes on form about privacy.

On the form

W-4 Federal Withholding Form - Nonresident (Form UC W-4NR/DE 4) - This form can be filled in electronically. Read notes on form about privacy.

Federal
State