Forms, Schedules & Resources

Action Forms

HRPOC-North & Luskin clients only

UCPath Personnel Action Forms by Action:

• • Termination/End of Appointment
  • Student FTE Change
  • Extension of Appointment
  • Reclassification
  • Stipend
  • Equity Increase
  • New Hire/Rehire/Concurrent Hire/Promotion/Demotion/Transfer
  • Contingent Worker
  • Other Actions

Please submit completed forms from above through the Bruin CHR Service Center.

HRPOC-South clients only

HR Action Forms (HRAFs) are available through Laserfiche, by selecting the appropriate link below. You must be an authorized Laserfiche user to access these forms. Please contact the HRPOC through the Bruin CHR Service Center if you need to gain access to Laserfiche.

• Hire Form
• Separation Form
• Other Transactions Form

Offer Letters

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

For internal promotions and employment offers that have no contingencies, please contact HRPOC Talent Acquisition to request 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

Please submit all completed forms through the Bruin CHR Service Center.

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 (optional)

Employee Performance Evaluation Information:

• • Performance Evaluation Form
  • Employee Self-Appraisal Form
  • Performance Evaluation Guide

Other:

• Brentview Medical Treatment Authorization Form
• Retired Employee Approval Form (UBEN 138)
• 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.
• Resources for Remote Working
• Work Study Posting — Template

Payroll Forms:

Please make sure you are submitting completed forms to the Bruin CHR Service Center.

• Automatic Meal Deduction Form
• AWS (Alternate Work Schedule) Agreement Form
• ERIT:
  • ERIT Program
  • ERIT Contract
  • ERIT Contract Amendment
• Kronos Correction Slip (DocuSign)
• Kronos Correction Slip (PDF)
• Comp Time Cashout Request Form
• Comp Time Rollover Request Form (SX)
• STAR Award Nomination Guidelines/Form
• Vacation Accrual Maximum Exception Request Form

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

Maps:

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

Calendars and Schedules

Calendars, Schedules & Deadlines:

• 2024 Kronos Payroll Calendar
• 2024 Biweekly Payroll Calendar
• 2024 TRS Employee & Supervisor Schedule
• 2024 Kronos Employee & Editor Deadline
• 2023 Biweekly Payroll Calendar
• 2023 Kronos Payroll Calendar
• 2023 Kronos Employee & Editor Deadline
• Kronos iCalendars: Downloadable iCalendar Importing Instructions
  • 2024 Kronos Edits Deadlines (iCal)
  • 2024 BW Employee Edits Deadline Reminder (iCal)
• ERIT Payroll Schedule
• Work Study Calendar