Required Forms Checklist for Hire/Rehire

Instructions:

  1. Print this checklist.
  2. Complete all forms as noted in the checklist below. Include Employee ID on all forms.
  3. Attach all forms except health insurance, other benefits forms (e.g., 403B forms), and alien documents (e.g. 8233 and tax treaty articles) to this checklist and send to Human Resources, Records Management Unit, 33 University Hall, Mail Code 3544. Use an HR pouch if available; if not, use a regular envelope.
Department: Today's Date:
Employee Name: Employee ID:
HR Administrator: Phone Number:
red checkmark Form Reference Hire Rehire
  State Oath of Allegiance UPAY585 R - US Citizens C - US Citizens
  Patent Policy Acknowledgement R - All Employees
  Employment Eligibility Verification
(Form I-9)		 Federal I-9 R C
   Benefits Eligibility Level Indicator (BELI) and Status Qualifier Code (SQC) UPAY 726 R C
N/A Demographic Data Transmittal U5605 Destroy after data entry into HRMS
  Payroll Earnings Distribution Authorization (Direct Deposit) UPAY 544A-1 R C
  Federal/State Withholding Allowance Certificate (Resident W4) UC W-4/DE 4 R C
  Health Insurance and other benefits forms (e.g., 403B, etc.) n/a C
  Alien Forms

Glacier

 C
 

Statement - Employment not Covered by Social Security Send to: UCHR Benefits, Records Management
P.O. Box 24570
Oakland, CA 94623-1570

UCRS 419 R-All employees not Covered by Social Security
  Conflict of Interest for Public Officials: Letter from UCB Controller's Office
http://hrweb.berkeley.edu/policy/newhire.doc
Disqualification Requirements
http://www.ucop.edu/ogc/coi/info.html
  1. Print both documents and give them to the employee.
  2. Check the box on the left to indicate the employee has received these documents.
 R
 

UC Policy on Substance Abuse to comply with Federal Drug Free Workplace Act
Print the following documents at the links shown, give to the employee, and check the box that you have done so:

 R-All employees
R - Required
C - Conditionally required. For detailed instructions, see Hire/Rehire Forms.