INFORMATION & FORMS
Alphabetical Listing by TitleListing by PER Form #
FORM NAMEFORM#
ADA FORMAL COMPLAINT INSTRUCTIONSPER4003
ADDITIONAL LIFE RATESPER1033
BENEFIT STATUS CODES/DEFINITIONSPER1202
BENEFITS - SELF FUNDED DENTAL PLANPER1031
BILINGUAL PROGRAM FORMPER59
BOARD OF SUPERVISOR'S POLICY: FLSAPER1053
CHANGE OF ADDRESS/TELEPHONE FORMPER1209
CIVIL SERVICE COMMISSION APPEAL FORMPER3125
CIVIL SERVICE COMMISSION APPEAL INFORMATIONPER3124
CLAIM AGAINST THE COUNTY OF SANTA CRUZ (Spanish)PER5003
DA INSPECTOR CELLULAR PHONE REIMBURSEMENT FORMPER7000
DISCRIMINATION/HARASSMENT COMPLAINTPER4002
DOMESTIC PARTNER AFFIDAVITPER1420
DONATION OF ACCRUED PAID LEAVE - TIME BANKPER1095
DOT REQUIREMENTS - EMPLOYEE NOTICEPER1507B
EEO REGULATIONSPER191
EEO/NONDISCRIMINATION & REASONABLE ACCOMODATION POLICY BROCHUREPER4027
EMPLOYEE CLAIM - EQUIPMENT LOSS/STOLENPER5006
EMPLOYEE OBLIGATIONS UNDER FMLAPER1084
EMPLOYEE PERFORMANCE EVAL AND DEV REPPER1171
EMPLOYEE REQUEST FOR TIME OFFPER1082A
EMPLOYEE REQUEST LOA W/OUT PAYPER1083
EMPLOYEE WELCOME - DEFERRED COMP LETTERPER1026
EMPLOYMENT ELIGIBILITY - I95 DOCUMENTATIONPER1022
EXTRA HELP EMPLOYMENT REQUIREMENTSPER1054
FMLA NOTICE - DA'S & EXEC MGTPER1061
FMLA NOTICE - DETENTION OFFICER UNITPER1060
FMLA NOTICE - GENERAL UNITPER1056
FMLA NOTICE - LAW ENF MID MGT UNITPER1059
FMLA NOTICE - LAW ENFORCEMENT UNITPER1057
FMLA NOTICE - MIDDLE MGT UNITPER1058
GRIEVANCE FORM - DA ATTORNEYS UNITPER1306
GRIEVANCE FORM - DEPUTY PROBATION OFFICER UNITPER7001
GRIEVANCE FORM - DETENTION OFFICER UNITPER1305
GRIEVANCE FORM - GENERAL REP UNITPER1301
GRIEVANCE FORM - LAW ENF MID MGT UNITPER1304
GRIEVANCE FORM - LAW ENFORCEMENT UNITPER1302
GRIEVANCE FORM - MIDDLE MGT UNITPER1303
GUIDE TO DEPARTMENTAL SELECTION INTERVIEWPER3061
HEALTH QUESTIONNAIREPER1025
INCIDENT REPORT FORM - NON EMPLOYEEPER5012
INPROCESSING - EH EMPLOYEE DOCUMENTSPER1021B
INPROCESSING - EH EMPLOYEE LETTERPER1020B
INPROCESSING - REG EMPLOYEE DOCUMENTSPER1021A
INPROCESSING - REGULAR EMPLOYEE LETTERPER1020A
INSURANCE SUMMARY - CORRECTIONAL OFFICERPER1030D
INSURANCE SUMMARY- DEPUTY PROBATION OFFICER ASSN UNITPER1030B
INSURANCE SUMMARY - GENERAL REPPER1030G
INSURANCE SUMMARY DA INSPECTORSPER1030T
INSURANCE SUMMARY - LAW ENFORCEMENT & SHERIFF'S SUPERVISORYPER1030L
INSURANCE SUMMARY - LAW ENFORCEMENT MIDDLE MANAGEMENTPER1030S
INSURANCE SUMMARY - MIDDLE/EXCUTIVE MANAGEMENT, ATTORNEYSPER1030M
INSURANCE SUMMARY - PHYSICIANSPER1030P
LONGEVITY FORM PER6056
MEDICAL AUTHORIZATION RELEASE FORMPER1142
NEW EMPLOYEE STATUS & INFO SUMMARYPER1040
NEW POSITION REQUEST/BOS ACTIONPER3039
NOTIFICATION OF POLICIESPER1063
PAYROLL CODES - UNFUNDED & PARTIAL YRPER1208
PAYROLL EMPLOYEE STATUS CODESPER1201
PAYROLL NAME CHANGEPER1205
PAYROLL TRANSACTION CODESPER1200
PAYROLL/PERSONNEL POSITION NUMBER CODESPER1203
PHYSICIAN'S CERT - FMLAPER1081B
PHYSICIAN'S CERT - LEAVE OF ABSENCE-EMPLOYEEPER1081A
PHYSICIAN'S CERTIFICATION - RETURN FROM LEAVEPER1086
PMI CAPITATION DENTAL PLANPER1032
POSITION DESCRIPTION FORM - LONG FORMPER65BF
POSITION DESCRIPTION FORM - SHORT FORMPER65AF
POSITION DESCRIPTION FORM SUPPLEMENT FOR SUPERVISORY POSITIONSPER66
PRE-EMPLOYMENT HEALTH QUESTIONNAIREPER1025B
PROPERTY LOSS REPORT FORMPER5013
PROPERTY LOSS REPORT FORM FOR DEPART OF PUBLIC WORKSPER5013DPW
REASONABLE ACCOMMODATION REQUESTPER1100A
REFERENCE CHECK - RELEASE/WAIVER FORMPER3011
REMOVE CANDIDATE FROM LIST REQUESTPER3151
REQUEST FOR CLASSIFICATION STUDYPER3116
REQUEST FOR MILITARY LEAVE-ACTIVE DUTYPER1073
REQUEST PLACE ON EMPLOYMENT TRAINING LISTPER3161
RESPONSE TO EMPLOYEE REQUEST FOR FMLA LEAVEPER1085
RETRAINING PAY ADJUSTMENT FORMPER1206
SAFETY SUGGESTION FORMPER6051
SALARY STUDY REQUESTPER1801
SALARY/COMP/LEAVE - APPTED DEPT HEAD/ASSTPER1041G
SALARY/COMP/LEAVE - BOARD & ELECTED DHPER1041H
SALARY/COMP/LEAVE - CORRECTION OFFPER1041I
SALARY/COMP/LEAVE - DA INSPECTOR UNITPER1041J
SALARY/COMP/LEAVE - GENERAL REP UNITPER1041A
SALARY/COMP/LEAVE - LE & SGTS UNITSPER1041B
SALARY/COMP/LEAVE - LEMM UNITPER1041D
SALARY/COMP/LEAVE - MGT TRAINEESPER1041E
SALARY/COMP/LEAVE - MID MGT UNITPER1041C
SALARY/COMP/LEAVE - OTHER EXEC MGT/DA ATTORNEYPER1041F
SALARY/COMP/LEAVE - PHYSICIANS’ REPRESENTATION UNITPER1041K
SEPARATION PACKETPER5300A
SEPARATION PACKET - EDDPER5300B
STATEMENT OF DOMESTIC PARTNER TERMINATIONPER1422
STUDENT WORKER SITE AGREEMENTPER3133
TUITION REIMBURSEMENT FORM - GENERAL REPPER1360
VEHICLE ACCIDENT REPORTPER5004
VIP - ACCIDENT FORMVIP
VIP - ACCIDENT POLICYVIP
VIP - APPLICATION PACKETVIP
VIP - AUTO INSURANCEVIP
VIP - DEPARTMENT REQUESTVIP
VIP - TIMESHEETVIP
VIP - TIPS FOR COMPLETING A DEPARTMENT REQUEST FORMVIP
VOLUNTARY REDUCTION OF HOURS FORMPER1088
VOLUNTARY TIME OFF FORMPER1089