Absence Report

Used internally by campus departments to report leave usage.

PA 634 (2/2004)

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: Monique.

(04/2009)

Action Request Form
INSTRUCTIONS FOR THIS FORM
GUIDELINES FOR THIS FORM

(Combines 3 forms in 1 - Status, Emergency/Limited-Term Appointment, & Recruitment Requisition Forms)
This form is used to request changes to the current employment status of an employee; request a limited-term, temporary appointment to a position vacancy for which recruitment is not required; and to initiate recruitment to fill all vacant state positions with the exception of student assistant, work-study student, graduate assistant, and positions in Unit 3.

(7/2007)

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 Form

Used to convey final selection after completion of interviews in a search.

OHRS-20-5
(11/2001)

Authorization for Moving and Relocation

Authorizes reimbursement for moving expenses.

OHRS-20-58
(3/2007)

Catastrophic Leave Donation Form

Donations of sick or vacation leave to employees of CSUN who are eligible for catastrophic leave.

OHRS-1-8
(12/2003)

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
(6/2009)

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). Note: Link to Enrollment Authorization form takes you to a State of California form. DIRECT DEPOSIT INSTRUCTIONS AND INFORMATION

STD 699
(7/2000)

Employee Action Request/Change Form
(Faculty/Staff/Management/Employee Only)

Employee Action Request Form is used to make changes to Federal and State Withholding and/or address changes. Remit completed form to HRIS/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
(12/2004)

Employee Information Change Form - State

Use for employee information changes such as address, telephone number, etc. Instructions are included with this form.

OHRS 30-72
(8/1999)

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
INSTRUCTIONS FOR THIS FORM

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
(02/2008)

Justification for Initiation of Search for Certain Personnel Appointments/ Actions in the General Fund for Academic Affairs (.htm)

       .dot version of this form (NEW!)

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.

(07/2007)

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
(11/2007)

Parking, Faculty & Staff

Used to obtain a parking permit.  The cost of the parking permit is determined by the employee's bargaining unit.

UCS
(4/2008)

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)

Performance Evaluation Form
MPP Performance Review and Assessment Tool

Used to evaluate MPP administrators and supervisors.

n/a
(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 Form

Used for general personnel action request for full-time and part-time faculty

n/a

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.

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.

PA 115
(8/2005)

Prior Pay Period Adjustment Form - 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-PSC-60-10
(11/2003)

Relocation Declaration of Reimbursement

Used to acknowledge compliance with conditions under which moving and relocation expenses shall be repaid.

OHRS 2065
(3/2005)

Retirement (Part-Time, Seasonal, Temporary) Distribution Form

Used to request payment of PST retirement funds after retirement or separation from State employment.

DC-3500
(1/2005)

Retirement Application for CalPERS

Used by members of CalPERS to apply for service retirement.

PERS-BSD-369-S

Selection Form

Used to convey final selection after completion of interviews in a search.

OHRS 205
(11/2001)

Separation/Clearance Designee Election Form

Used to designate an employee responsible for completing all department separation/clearance processes.

OHRS 30-73
(3/1999)

New! 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
(6/2009)

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 access to the HR system for an individual employee.

(6/2008)

Special Pay Authorization (recommended - .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. Remit completed form to HRIS/Payroll Administration, UN-165 with original signature and date. No photocopies accepted. Link to form takes you to State of California forms website.

STD 457
(9/2004)

Student Assistant Payroll Summary
INSTRUCTIONS FOR THIS FORM

Monthly payroll summary for Student Assistant workers in campus departments. Will accommodate up to 25 students.

OHRS PSC 60-1
(8/2005)

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
(4/2008)

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
(1/2002)

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.

N/A
(7/2002)

U.S. Savings Bond Purchase/Payroll Deduction Authorization

Used to request automatic payroll deduction of funds for the purpose of purchasing US Savings Bonds.

STD 242
(12/2005)

Vehicle Monthly Usage Report

Used by employees to report mileage on their state or third-party vehicles.

OHRS-PSC-60-7
(10/2004)

Vision Out-of-Network Reimbursement Form

Use in the event that you see an out-of-network provider for vision services.

n/a
(1/2007)

Vision (Video Display Terminal Claim Form)

Computer Eyewear Only

n/a
(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

The Waiver of Recruitment & Appointment Requisition Form is used when requesting an emergency hire appointment to a position vacancy for which recruitment is not required.

OHRS TUC-WVR
(9/2005)