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
Counseling
Discipline
- TBD
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
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]
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)
Employment
Interview Data Form and Physical, Environmental, and Mental Demands (PEM) form
Labor Relations
Appointment & Reappointment Letters
Compensatory Time Off (CTO)
Contracts (forms and sample letters)
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
- Hire/Rehire Required Forms Checklist
- 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)