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The forms in this section are generally in Microsoft Word (.doc) or Portable Document Format (.pdf). PDF files can be viewed by using the Adobe Acrobat Reader, which is available free from the Adobe site. Adobe Reader 7.0 or higher is recommended.
Benefits
Many benefits forms and publications can be found online or ordered from the KP Supply Warehouse.
Employment Events: Rehiring Retirees
- Retired Employee Approvals Form (PDF) (UBEN 138)
- UC Berkeley Supplement to the Retired Employee Approvals Form (PDF)
- UCRP Reemployed Retiree Notification Form (PDF) (UBEN 1039)
Rehiring UC Retirees
- Rehire Approvals Form (PDF) (UBEN 138)
- UCRP Reemployed Retiree Notification Form (PDF) (UBEN 1039)
- UC Berkeley Supplement to the Retired Employee Approvals Form (PDF)
Retirement & Retirement Savings Plans
Compensation & Classification
Equity Increase
Diversity & Inclusion
Demographic Data
- Transmittal Form (PDF)
Employee & Labor Relations
Appointment & Reappointment Letters
Background Check
- Employee/Applicant Release and Disclosure Form (PDF)
- Sample Notification Letters:
- New Hires (Word)
- Reclassification or Assignment of New Duties (Word)
- Transfers (Word)
Catastrophic Leave Sharing Program
Childcare Reimbursement
Compensatory Time Off (CTO)
- TBD
Contracts (forms and sample letters)
Family & Medical Leave Packet
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Certifications
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Pregnancy Disability (PDF)
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Return to Work (PDF)
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Forms, Checklists and Facts
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Military Certifications
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Caregiver Leave (PDF)
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Letters
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See sample letters on UCnet
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Other
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Leave Usage Tracking Form (Excel)
Grievance Forms (Represented Employees)
Investigations & Investigatory Leave
Layoff
- Represented Employee Layoff/Reduction in Time Templates can be found on the Labor Forms & Letters webpage
Medical Separation
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Notice of Leave of Absence and Special Placement Consideration (90 day transfer search) (Word)
- Request for Review (Campus Accommodation and/or Medical Separation) form (Word) - please review the instructions before filling out this form
Military Leave
Miscellaneous Template Letters
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TBD
MSP Separation
Payroll Deduction Authorization (Agency Fees)
Performance Evaluation
Performance Management, Corrective Action, & Disciplinary Action
Pregnancy Disability Leave (PDL)
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Employee FML Eligible (PDF) - For combined PDL and Parental Leave
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Employee FML Eligible (PDF) - For Requests Limited to PDL
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Employee FML Eligible but Leave Entitlement Exhausted (PDF) - For Requests for PDL only
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Employee Not FML Eligible (PDF) - For requests for PDL only
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Letter for Change in End Date of PDL (PDF) - For Approved Combined PDL and Parental Leave
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Medical Certification for Employee's Pregnancy Disability (PDF)
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PDL Confirmation Letter (PDF) - Employee Not FML Eligible or Employee FML Eligible but Leave Entitlement Exhausted
- Return to Work Certification (PDF)
Probationary Period Management
Proof of Service
Employment
Interview Data Form and Physical, Environmental, and Mental Demands (PEM) form
Learning & Development
Career Development
Performance Management
Non-Represented Staff Performance Review Forms
Records Management
Hiring Forms
- Demographic Data:
- HCM Instructions (PDF)
- Transmittal Form (PDF)
- E-Verify & I-9:
- UPAY 585–State Oath of Allegiance and Patent Agreement (PDF)
- W-4:
- Federal Withholding Form - Resident (Form UC W-4/DE 4) (PDF) - This form can be filled in electronically. Read notes on form about privacy.
- Federal Withholding Form - Nonresident (Form UC W-4NR/DE 4) (PDF) - This form can be filled in electronically. Read notes on form about privacy. More information on taxation forms for non-residents.
- Instructions for Entering W-4 Tax Allowances via At Your Service Online (PDF)