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 Relations
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
Compensatory Time Off (CTO)
- Labor Contracts
Family & Medical Leave Packet
- Certifications
- Medical Leave Form for Employees (PDF)
- Medical Leave Form for Family Member (PDF)
- Pregnancy Disability (PDF)
- Return to Work (PDF)
- Forms, Checklists and Facts
- Military Certifications
- Caregiver Leave (PDF)
- Qualifying Exigency Leave (PDF)
- Letters
- See sample letters on UCnet
- Other
Investigations & Investigatory Leave
Layoff
Labor Contract
Medical Separation
- 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
- TBD
MSP Separation
- Notice of Intent to Separate MSP (position elimination)
- Notice of Intent to Reduce MSP Appointment Percentage
- Letter of MSP Separation (position elimination when employee responds)
- Letter of MSP Separation (position elimination when employee does not respond)
- Letter of MSP Reduction in Time (when employee responds)
- Letter of MSP Reduction in Time (when employee does not respond)
- Working Document [MSP]
Performance Management, Corrective Action, & Disciplinary Action
- Final Notice of Discipline: Suspension Template
- Final Notice of Discipline: Termination Template
- Letter of Counseling (LOC) Template
- Letter of Warning (LOW) Template
- No Call/No Show Letter Template
- Notice of Intent to Suspend (NOIS) Template
- Notice of Intent to Terminate (NOIT) Template
- Notice of Intent to Terminate (NOIT): Job Abandonment Template
- Notice of Suspension Template
Pregnancy Disability Leave (PDL)
- Employee FML Eligible (PDF) - For combined PDL and Parental Leave
- Employee FML Eligible (PDF) - For Requests Limited to PDL
- Employee FML Eligible but Leave Entitlement Exhausted (PDF) - For Requests for PDL only
- Employee Not FML Eligible (PDF) - For requests for PDL only
- Letter for Change in End Date of PDL (PDF) - For Approved Combined PDL and Parental Leave
- Medical Certification for Employee's Pregnancy Disability (PDF)
- PDL Confirmation Letter (PDF) - Employee Not FML Eligible or Employee FML Eligible but Leave Entitlement Exhausted
- Request to Continue/Cancel Benefits While on Leave (PDF)
- Return to Work Certification (PDF)
Probationary Period Management
Employment
Interview Data Form and Physical, Environmental, and Mental Demands (PEM) form
Labor Relations
Appointment & Reappointment Letters
Childcare Reimbursement
Compensatory Time Off (CTO)
Contracts (forms and sample letters)
Grievance Forms (Represented Employees)
- Academic Student Employee Unit (BX/UAW 2865) Grievance Form
- Clerical & Allied Services Unit (CX/Teamsters 2010) Grievance Form
- Graduate Student Researchers Unit (BR/UAW 2865) Grievance Form
- Health Care Professional Unit (HX/UPTE) Grievance Form
- Non-Senate Instructional Unit (IX/UC-AFT) Grievance Form
- Patient Care Technical Unit (EX/AFSCME) Grievance Form
- Police Officers Unit (PA/FUPOA) Grievance Form
- Postdoctoral Scholar Unit (PX/UAW 5810) Grievance Form
- Professional Librarian Unit (LX/UC-AFT) Grievance Form
- Registered Nurses Unit (NX/CNA) Grievance Form
- Research Support Professional Unit (RX/UPTE) Grievance Form
- Service Unit (SX/AFSCME) Grievance Form
- Skilled Crafts Unit (KB/ACBCTC) Grievance Form
- Student Health Service Physicians Unit (DX/UAPD) Grievance Form
- Technical Unit (TX/UPTE) Grievance Form
Payroll Deduction Authorization (Agency Fees)
Performance Evaluation
Proof of Service
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)