Forms, Schedules & Resources

Recruitment Authorization

Approval from the Vice Chancellor/Dean is currently required for the HRPCN to process client department’s recruitment and appointment extension transactions. Please utilize and submit the Recruitment Authorization Form (RAF), also known as the VC Authorization Form, below to obtain and indicate the necessary authorization before beginning the recruitment process.

Recruitment Authorization Form (DocuSign)

Recruitment Authorization Form (PDF)

The current hiring and RAF submission processes are detailed on the New Protocols for Hiring webpage.

Offer Letters

Use the Contingent Offer Letter Template for all offers that have pre-employment contingencies.

For internal promotions and employment offers that have no contingencies, please contact HRPOC Employment for assistance with a combination letter.

For more information on Employment Offer Letters, visit the New Hire Process page.

Welcome Letter Templates

Different Welcome Letters Templates will be used based on the collective bargaining agreement/policies covering the position and the appointment type the individual is being hired in to.

Forms

For Luskin Conference Center, Lake Arrowhead, Catering, Faculty Center, and Guest House, please email all completed forms to LCC-HumanResources@chr.ucla.edu.

For all others, please email all completed forms to HRPCNorth@ucla.edu for processing.

Benefits/Worker’s Compensation Forms:

• Enrollment, Change, Cancellation or Opt Out Form (UPAY850) [PDF]
• Notice to UC of a COBRA Qualifying Event Form (UBEN 109)
• Incident Report and Referral for Medical Treatment
• TRTW Agreement Template
• UCLA Campus Catastrophic Leave Program – Donor Form
• UCLA Campus Catastrophic Leave Donation Program – Recipient Application

Compensation Forms:

• HRPOC Individual Salary Action Authorization Form

Employee Performance Forms:

• Policy Covered (Non-Represented) Employee Performance Evaluation Forms:
  • Policy Covered (Non-Represented-99) Employee Performance Evaluation Form
  • Policy-Covered (Non-Represented-99) Employee Self-Appraisal Form

• Represented Employee (Staff Covered by a Collective Bargaining Agreement) Performance Evaluation Forms:
  • CX (Teamsters-Clerical) Employee Performance Evaluation Form
  • SX (AFSCME) Employee Performance Evaluation Forms:
    • Dining SX (AFSCME) Employee Performance Evaluation Form
    • Non-Dining SX (AFSCME) Employee Performance Evaluation Form
  • K4 (Teamsters-Skilled Crafts) Performance Evaluation Form
  • TX (UPTE-Technical) Performance Evaluation Form

Fingerprinting/Recruiting Forms:

• BCIA 8016 – Request for Live Scan Service
  • Please do not complete the Social Security number line of this form.
• Background Check (Criminal Record) Authorization
• Brentview Medical Treatment Authorization Form

Payroll Forms:

• Automatic Meal Deduction Form
• Authorized Signature Forms
• AWS (Alternate Work Schedule) Agreement Form
• Blood Donation Electronic Submission to the HR & Payroll Center – North office
• ERIT Program
• ERIT Contract
• ERIT Contract Amendment
• HRPOC Individual Salary Action Form
• Kronos Correction Slip
  • Kronos Correction Slip via DocuSign
• Retired Employee Approval Form (UBEN 138)
• STAR Award Nomination Form
  • FY20-21 STAR Award Guidelines
• Temporary Telecommute Agreement (Word Version)
• Temporary Telecommute Agreement (DocuSign Version)
  • Please review the Telecommuting Guidelines before submitting a Telecommuting Agreement form.
  • The form can only be filled out/completed utilizing an employee’s official UCLA e-mail address.
• Resources for Remote Working
• The UCLA Employment Application is to be used when hiring students. It should also be used when hiring staff in the following classifications: limited appointment and per diem, where the recruitment process was done outside the PeopleAdmin system.
• Vacation Accrual Maximum Exception Request Form
• UCPath Personnel Action Form (PAF) – DO NOT USE FOR SEPARATIONS. *Please use Termination UCPath PAF below.*
  • DocuSign Version of the UCPath PAF
    • Termination UCPath PAF
    • Extension UCPath PAF
  • DocuSign Version of the UCPath PAF for Luskin Conference Center, Lake Arrowhead, Catering, Faculty Center & Guest House
• Work Study Posting — Template

DMV Pull Forms:

• Driver’s License Employer Pull Notice Program Applicant Information
• Employer Pull Notice (EPN) Program Driver’s License Notification to Employees
• UCLA Employer Pull Notice (EPN) Program – Add, Delete, Update Form

Resources

Benefits:

• Guide to Filing for Disability
• Pregnancy, Newborn, Adoption Fact Sheet
• UCRP/CalPERS Reciprocity Fact Sheet and Election Form
• Your Guide to UC Disability Benefits

Employee Resources:

• Behavioral Intervention Team (BIT) Brochure
• Career Information for Veterans
• Employee Ergonomics
• Employment, Income Verification through The Work Number
• Resources for Veterans
• Staff & Faculty Counseling Center (SFCC) Brochure
• Staff 911 Guide for Students (Red Folder)
• Understanding Your Direct Deposit Statement
• Whistleblower Policy

New Hire/Manager Resources:

• List of Acceptable Documents for I-9
• List of Jobs Requiring Physicals
• HHS Manager and Supervisor Toolkit
• New Hire Flowchart
• Separation Reason Code Description

Compliance

The link below contains all workplace posters required to be posted as well as posting guidelines:

• UCLA Required Workplace Posters

Once posted, complete and submit the following Mandatory Workplace Postings form (submission instructions are on the form).

Maps:

• Directions Guide to get to the HRPC — North Office
• UCLA Campus Map
• UCLA Interactive Map

Calendars and Schedules

Calendars:

• 2021 Biweekly Payroll Calendar
• 2022 Biweekly Payroll Calendar
• 2022 Monthly Payroll Calendar
• Work Study Calendar

Schedules and Deadlines:

• 2020 HRPC – North / UCPath Pay Adjustment Deadlines_Kronos
• 2020 HRPC – North / UCPath Pay Adjustment Deadlines_TRS
• 2021 Kronos Edits Deadlines- Bi-weekly
• 2021 Kronos Edits Deadlines- Monthly
• 2021 TRS Employee & Supervisor Schedule
• Kronos iCalendars: Downloadable iCalendar Importing Instructions
  • Downloadable iCalendar – Kronos BW Edit Deadlines 2020
  • Downloadable iCalendar – Kronos MO Edit Deadlines 2020
  • Downloadable iCalendar – Kronos BW Employee Reminder 2020
• ERIT Biweekly Payroll Schedule

Inquiries and Feedback

We want to help. If you have questions, please submit the HRPC-N Feedback Form, and we will respond promptly.

Your feedback is important to us. Please submit any comments or recommendations via the HRPC-N Feedback Form for review and consideration.