Return to CSUN Homepage
Page Description

The following page is a three column layout with a header that contains a quicklinks jump menu and the search CSUN function. Page sections are identified with headers. The footer contains update, contact and emergency information.

OFFICE OF HUMAN RESOURCES

Human Resources Forms A to Z:

FORM TITLE DESCRIPTION NAME
Absence Report Used internally by campus departments to report leave usage. PA-634 (10/2011)
Access Personnel File Form For employees wishing to view their personnel files. The completed form should be return to HR/mail drop 8229 or faxed to
(818) 677- 7200, Attn: Cindy Mitchell.
(04/2009)
Action Request Form - State This form is used for changes only. Appointment transactions are done through Recruiting Solutions on the portal. For instructions and quickguides on using Recruiting Solutions, please visit the Jobs@CSUN website. OHRS-20-66 ST (11/2010)
Action Request Form - Auxiliary This form replaces the Waiver of Recruitment & Appointment Requisition Form - Auxiliary. OHRS-20-66 AUX (5/2011)
Applicant Interview Evaluation Record Used to evaluate candidates interviewed during a search. OHRS-20-54 (12/2000)
Applicant Screening Record Used for screening and rating applications. OHRS-20-55 (12/2000)
Applicant Selection and Disposition Form- Auxiliary Used to convey final selection after completion of interviews in a search. OHRS-205 AUX (5/2011)
Authorization for Moving and Relocation Authorizes reimbursement for moving expenses. OHRS-20-58 (3/2007)
Benefits Enrollment Worksheet The Benefits Enrollment Worksheet is used by new employees at Sign-In or by current employees to indicate changes to Benefit Plans at qualifying times. (1/2013)
Campus Timesheet Used by Student Assistant, Work-Study, and Hourly employees to track their hours worked. PA-100 (11/2011)
Catastrophic Leave Donation Form Donations of sick or vacation leave to employees of CSUN who are eligible for catastrophic leave. OHRS-1-8 (2/2011)
Catastrophic Leave Donation Program Used to request participation in the Catastrophic Leave donation Program. OHRS-3079 (4/2004)
Classification Appeal Used for Employee notice of classification appeal. OHRS 10-2 (11/2004)
Confidentiality Statement, Faculty/Staff Use this form for access to University data systems containing personal, academic, or financial information about students, faculty, staff, or alumni. OHRS 50-15 (6/2008)
Delta Dental DPO Claim Form Used for dental services rendered. Form is to be taken to dental office for completion. DELTA 105 (7/2003)
Direct Deposit: Complete both forms:

1 - Direct Deposit Enrollment Authorization

2 - Direct Deposit Contract
Used to enroll in or change direct deposit of pay warrants (return with signature to Payroll Administration, University Hall Room 165; questions, call x2101). STD 699 (10/2013)
Employee Action Request (EAR) Form

The Employee Action Request Form is used to make changes to Federal and State Withholding and/or address changes for Faculty, Staff, and Administrators only. Remit completed form to Payroll Administration, UN-165 with original signature and date. No photocopies accepted. Link to form takes you to a State of California form. STD 686 (7/2007)
Employee Condifentiality Statement (Faculty and Staff) Confidentiality statement for employee access to university data systems containing personal, academic, or financial information about students, faculty, staff or alumni. OHRS 50-15 (2008)
Employee Information Form (EIF) - State & Auxiliary Employee The Employee Information Form is completed by all State & Auxiliary Employees at Sign-In. The EIF provides the University with contact, education, payroll designee and emergency contact information. The EIF also contains the "Oath of Allegiance." The EIF is also used to advise the University of changes in contact information (address, telephone number, etc). Instructions are included with this form. OHRS 30-72 (3/2011)
Employee Transfer Data Form - State This form is used to obtain personnel data regarding employees transferring from another CSU or State agency. STD 612 (6/2001)
Employment Application All applications are now completed online. Please visit http://www-admn.csun.edu/ohrs/employment (8/2008)
Exit Interview Questionnaire Staff members are encouraged to complete and submit this form to Human Resources when separating from the university. (4/2008)
Extra Hours Worked Authorization Used by campus employees to document their overtime, CTO, or straight time worked in excess of their regular schedule. PA 125 (4/2004)
Extra Hours Worked, Control Log CTO
Instructions for This Form
Monthly control log used to summarize all of the CTO (Compensatory Time Off) credits earned by employees. Must be submitted with "Authorization for Extra Hours Worked" sheet(s). OHRS PSC 60-66 (8/2005)
Extra Hours Worked, Control Log Straight Time
Instructions for This Form
Monthly control log used to summarize all of the overtime/straight time cash payments due to employees. Must be submitted with "Authorization for Extra Hours Worked" sheet(s) OHRS PSC 60-5 (8/2005)
In-Range Progression Request Form Used to request an increase within a salary range for a single classification, or within a sub-range of classification. OHR 10-17 (03/2011)
Justification for Initiation of Search for Certain Personnel Appointments/ Actions in the General Fund for Academic Affairs
This form is to be completed and attached to the Personnel Requisition for all requests to initiate a search for management, probationary, and temporary renewable staff appointments; and extensions of temporary renewable appointments of six months or more in the General Fund for Academic Affairs. OHRS 20-62 (01/2004)
Leave of Absence Request Form This form is used to request a Leave of Absence or request to return to work from a leave. (01/2013)
Master Payroll Certification (MPC) Exception Form Use this form to report monthly master payroll transactions missed during the regular MPC cycle. MPC Form (1/2006)
New Employee Sign-In Form Used for new employee sign in. OHRS 20-56 (10/2013)
Parking, Faculty & Staff Used to obtain a parking permit. The cost of the parking permit is determined by the employee's bargaining unit. UCS (7/2011)
Pay Warrant Pick Up Request
- December 31, 2013
Employees who want to pick up their warrants on December 31st must complete the Pay Warrant Pick Up Request Form no later than December 18, 2013 and return it to University Cash Services, Bayramian Hall 100R (Mail Drop 8214). (10/2013)
Pay Warrant Replacement
- Lost/Stolen
Used by employees to request a duplicate pay warrant / stop payment (return with Signature to Payroll Administration, University Hall Room 165, questions, call x2101). Link to form takes you to State of California forms website. STD 435 (9/2000)
Payroll Designee Form
“Designation of Person(s) Authorized to Receive Warrants”
Used to designate the person(s) entitled to receive all outstanding pay warrants upon the employee´s death. STD 243 (11/2013)
Performance Evaluation Form
- MPP Performance Review and Assessment Tool
Used to evaluate MPP administrators and supervisors. (7/2007)
Performance Evaluation Form (Unit 4) Used to evaluate performances for employees within Unit 4. OHRS 20-49 (12/2005)
Performance Review Used to evaluate all support staff (instructions included with form). OHRS 30-11 (8/2002)
Personnel Action Request (PAR) Form Used for general personnel action requests for Academic Personnel including Full-Time and Part-Time Faculty, and Academic Student Employees. (3/2010)
Position Description Form - TUC Used by the University Corporation to provide the employee with a written description of the duties for which he or she is responsible. OHRS TUC 10-11 (4/2005)
Position Description Form - MPP Used to develop the Performance Program for MPP positions. Formerly the Performance Program - MPP Positions form. OHRS 1-9 (2/2003)
Position Description Form - Staff Used to provide the employee with a written description of the duties for which he or she is responsible. This form is used by the University, Associated Students and University Student Union. OHRS 10-09 (11/2004)
Prior Pay Period Adjustment Form Used by campus departments to request adjustments to an employee's pay and/or leave balance, including sick leave, CTO, and vacation usage from a prior pay period.
Do not use this form for Work-Study prior pay period adjustments - use the next form below.
PA 115 (8/2005)
Prior Pay Period Adjustment Form - Federal Work-Study Summary to report miscellaneous adjustments to Work-Study Payroll, including hours from a prior pay period. Use for on and off campus Work-Study. (Instructions included with form.) OHRS C-80-10 (2/2011)
Relocation Declaration of Reimbursement Used to acknowledge compliance with conditions under which moving and relocation expenses shall be repaid. OHRS 2065 (3/2005)
Retirement Application for CalPERS Used by members of CalPERS to apply for service retirement. PERS-BSD-369-S
Selection Form - Auxiliary Used to convey final selection after completion of interviews in a search. OHRS 205 AUX (9/2009)
Separation/Clearance Designee Election Form Used to designate an employee responsible for completing all department separation/clearance processes. OHRS 30-73 (3/1999)
Separation/Clearance Form For all faculty and staff who are separating employment from CSUN. Full and part-time faculty members who are expected to return during the following semester may be exempt from this process, at the discretion of the Dean of the College. OHRS 30-23 (3/2010)
Signature Authorization, Payroll Documents Used by campus departments to notify HRIS/Payroll Administration of persons authorized to sign payroll documents. OHRS PSC 60-16 (2/2004)
SOLAR HR Access Request Form Use this form to request or change access to the HR system for an individual employee. (6/2013)
Special Pay Authorization (xls)
Special Pay Authorization (HTML)
Instructions for this Form
Used by campus departments to request payments for hours, units, or days worked on projects falling under the "Special Pay" classifications. PA 120 (3/2005)
Special Pay Faculty Pre-Hire Processing Used to initiate job prior to processing special pay authorization (above). OHRS 50-14 (12/2008)
Student Payroll Action Request/Change Form CSU Student Payroll Action Request Form is used to make changes to Federal and State Withholding and/or address changes. Complete and remit page 2 only to HRIS/Payroll Administration, UN-165 with original signature and date. No photocopies accepted. This link takes you to the State of California form. STD 457 (9/2004)
Student Assistant Hire Form Use this form to document the hire of a new Student Assistant. OHRS 20-60 (10/2001)
Student Employee Job Data Change Form This form is used to document and authorize requests for additional appointment or change to the current employment status of a student assistant or work-study student. OHRS 20-57 (2/2013)
Summer Session YRO Pay, Authorization Used by campus departments to request payments for faculty involved in the year-round operations. PA 110 (8/2005)
Summer Session, 1/30th Pay Rate Used by campus departments to report summer session pay for faculty that worked the previous fall or spring. PA 130 (6/2005)
Summer Session, 2357 Salary Schedule Used by campus departments to report faculty teaching summer only. PA 135 (6/2005)
Timesheet Used by Student Assistant, Work-Study, and Hourly employees to track their hours worked. PA-100 (11/2011)
Transfer of Leave Balance from Position to Position, Authorization When an employee has multiple positions and is earning vacation or sick leave in more than one job, the employee may transfer hours between positions. This transfer is allowed when there is an insufficient balance in the second position and the employee needs a specific amount to cover a time off for a specific time period. (7/2002)
Vehicle Monthly Usage Report Used by employees to report mileage on their state or third-party vehicles. OHRS-PSC-60-7 (10/2004)
Veteran Self-Identification Form Staff, faculty and auxiliary employees may voluntarily report their veteran status. OHRS-VSID (8/2009)
Vision Out-of-Network Reimbursement Form Use in the event that you see an out-of-network provider for vision services. (1/2007)
Vision (Video Display Terminal Claim Form) Computer Eyewear Only (1/2007)
Volunteer Form
CSU Volunteer Policy
Used for processing CSUN Volunteer workers.
Volunteer Sign-In Process Instructions
OHRS 20-64 (6/2005)
W-2 Duplicate Request Used to request a duplicate copy of a W-2 for up to 4 prior tax years. STD 436 (9/1997)
Waiver of Recruitment & Appointment Requisition Form - Auxiliary This form has been replaced by the
Action Request Form - Auxiliary.
OHRS TUC-WVR (9/2005)
Work Schedule Changes Please use the Action Request Form to make work schedule changes. n/a