San Jose State University : Human Resources

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ALL STAFF FORMS

 

Accidents
Special Event Report of Injury or Loss (PDF)
State Driver Accident Review (PDF)
Student Accident Report (.doc)
Vehicle Accident Identification Card (PDF)
Vehicle Accident Report (PDF)
Visitor Accident Report (.doc)
Benefits
Affidavit of Marriage (PDF)
eBenefit Self-service Electronic Signature Form (PDF)
Employer Zip Code Election (PDF)
Benefits, COBRA
COBRA Continuation Election (PDF)
Benefits, Supplemental Saving Program
CSU Certification of Establishment 403b TSA (PDF)
Tax Sheltered Annuity Final Settlement Deductions (PDF)
US Saving Bonds Purchase/Payroll Deduction Authorization (PDF)
Benefits, Vision
VSP Out-of-Network Reimbursement (PDF)
VSP Video Display Terminal Confirmation (PDF)
Classification and Compensation
Classification and Compensation Position Review Request Form (.doc)
Position Description Questionnaire (.doc)
Request for Salary Stipend CSUEU (.doc)
Staff Position Description Template (.doc)
Data and Technical
Data Request (.doc)
Discrimination
Discrimination Complaint Form (PDF)
Domestic Partners
Declaration of Domestic Partnership (PDF)
Domestic Partner Dependent Certification (PDF)
Employee Separation
Confidential Exit Survey (.doc)
Employee Clearance (.doc)
Employee Profile
Employee Profile (PDF)
Release of Confidential Information (PDF)
Family Care Medical Leave
Employees Request for Leave of Absence (PDF)
FCML Certification (PDF)
Return to Work Certification (PDF)
Fee Waiver
Continuing Staff Career Development Update Application (PDF)
Staff Dependent Fee Wavier Entitlement Transfer (PDF)
Staff Fee Waiver Application for Change of Courses (PDF)
Staff Fee Waiver Career Development Application (PDF)
Staff Fee Waiver Job Related Application (PDF)
Health Insurance Portability And Accountability Act (HIPAA)
Authorization to Use and/or Disclose Personal Health Plan Information (PDF)
Request for Access to Inspect and Copy Personal Health Plan Information (PDF)
Request for Accounting of Non-Routine Disclosures of Personal Health Plan Information (PDF)
Request for Confidential Communications of Personal Health Plan Information (PDF)
Request for Restricted Use of Personal Health Plan Information (PDF)
Request to Amend Personal Health Plan Information (PDF)
Leave Programs
Catastrophic Leave Medical Certification (PDF)
Difference in Pay Military Worksheet (PDF)
Election to Continue Direct Pay for Employees on Leave of Absence (PDF)
Request for Catastrophic Leave Donations (.doc)
Request for Leave of Absence (PDF)
Request to Participate in the Catastrophic Leave Donation Program (PDF)

ALL STAFF FORMS

 

Parking
Pre-Tax Parking Deduction Election Authorization (PDF)
Payroll
Absence and Addition Time Worked Report (.xls)
Authorization for Extra Hours (Overtime) (.doc)
Cancellation of Payroll Deduction (PDF)
CSU Certification of Establishment of 403(b)Tax Sheltered Annuity Account (PDF)
Direct Deposit Enrollment Authorization (PDF)
Duplicate W2 Wage and Tax Statement Request Form (PDF)
Employee Action Request EAR (PDF)
Employee Appointment Form (PDF)
Hourly Time Sheet (.xls)
Reporting Informal Leave without Pay (Docks) (PDF)
Request for Excess Vacation Accrual Carry-Over (.doc)
Request for Salary Advance (.doc)
Request for Substitute Faculty Payment (.doc)
Special Consultant Payment (.doc)
Performance Review
CSUEU Staff Performance Review (.xls)
CSUEU Staff Pre-Performance Review Worksheet (.doc)
CSUEU Staff Probationary Performance Review (.xls)
Evaluator Letter for Staff Pre-Performance Review Input Template (.doc)
Report of Employee Performance Unit 4 Academic Support (.doc)
Staff Performance Review Units 1,6,8 (.xls)
Staff Performance Review Guidelines for Writing Effective Goals Worksheet (.doc)
Staff Position Description Template (.doc)
Staff Pre-Performance Review Worksheet Units 1,6,8 (.doc)
Temporary Support Performance Evaluation (PDF)
Unit 4 Academic Professionals of California Staff Plan (.doc)
Recruitment
Request for Temporary Support (.doc)
Special Events
Special Event Report of Injury or Loss (PDF)
Special Events Liability Insurance Request (PDF)
Special Events Release Agreement (PDF)
Travel
Conduct Agreement (PDF)
Student Accident Report (.doc)
Student Travel Informed Consent (.doc)
University Activity Release Agreement Guidelines (PDF)
Vehicle Operation
Application for University Vehicle Operation Authorization (PDF)
Authorization to Use Privately Owned Vehicles on State Business (PDF)
State Driver Accident Review (PDF)
Vehicle Accident Identification Card (PDF)
Vehicle Accident Report (PDF)
Volunteering
Volunteer Appointment (.doc)
Worker's Compensation
Employers Report of Occupational Injury or Illness (PDF)
Notice of Personal Chiropractor or Acupuncturist (PDF)
Workers Compensation Claim Form (DWC 1) And Notice of Potential Eligibility (PDF)
Occupational Injury or Illness Checklist (.doc)
Notice of Pre-designation of Personal Physician (PDF)
Workers' Compensation Facts for New Employees (PDF)

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