Documents / Forms

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Documents / Forms

Benefits

Health Care

Affidavit of Parent-Child Relationship

Allows for the enrollment of a child (other than natural, adopted or step-child) in the CalPERS sponsored health programs.

Benefits Enrollment/Change Form

A worksheet for employees to designate their dental, medical and flexcash options (opting out of benefits).

Declaration of Health Care Coverage

A CalPERS-required form for enrolling into or opting out of benefits.

Delta Dental Claim Form

Used by employees if a Delta Dental provider does not bill directly for services.

HIPPA Authorization Form

Employee Authorization for Benefits staff to use and/or disclose personal health plan information.

VSP Out-of-Network Reimbursement Form

Vision reimbursement form for employees who utilized the services of a non-network doctor.

VSP Video Display Terminal (VDT) Confirmation Form

Vision form for employees who meet the job requirements for the VDT benefit that is given to a VSP Network doctor.

Flexible Benefits

Dependent Care/Health Care Claim Form

Used to establish a dependent and/or health care reimbursement account.

Dependent Care/Health Care Reimbursement Account Plans Enrollment Authorization

Enrollment form used to establish Health Care and/or Dependent Care reimbursement accounts.

Direct Deposit Form for Dependent Care/Health Care

For employees who wish to receive their Flexible Spending Accounts reimbursements by direct deposit.

FlexCash Program Enrollment Authorization

Forms used to “opt out” of medical and/or dental benefits.

Medical-Related Leaves

Leave of Absence Request Form

For employees who wish to request a leave of absence for medical, family medical leave, parental, pregnancy, military, education, personal or other leaves.

Survivor Protection Benefits

Life and AD&D Beneficiary Designation and Change Form

To designate or change the beneficiary of the employer-paid Life and AD&D benefit.

Retirement Plans

TSA Maximum Contribution Worksheet

For individuals who want to contribute more than the annual maximum and are age 50 or older and/or a 15-years of service.

Fee Waiver

Career Development Plan

To be completed by employees who are pursuing a degree program.

CSU $55 Application Fee Waiver

Allows for the waiver of the application fee to one CSU campus.

Dependent Fee Waiver Form

To be used when eligible dependents will be utilizing the employee’s fee waiver benefit.

Employee Fee Waiver Form

To be completed by employees who will be utilizing the fee waiver benefit.

Director’s Office

CSU Conflict of Interests Disclosure Categories

The list gives employees in designated positions a description of each category that is required to submit the Form 700 Statement of Economic Interest form annually.

Form 700 Statement of Economic Interest

Form 700 pamphlet includes instructions and forms for employees in designated positions to complete the form annually.

Political Reform Act 2008

A description of the Political Reform Act published by the Fair Political Practices Commission.

San Diego State University Designated Positions

List of Designated Positions associated with the Statement of Economic Interest. The list is established through the Chancellor’s Office.

Employee & Organization Development

President’s Management Development Application Form

Application form that is submitted in August.

Employment & Classification

Compensation

Discretionary Pay Increase Unit 4 Recommendation

Form used to request a discretionary pay increase for Unit 4 employees.

In-Range Progression Guidelines and Forms

Form used to submit an in–range progression request.

Employment

Confidential Employees Human Resources Program Guidelines

Guidelines pertaining to the confidential classifications.

Employment Verification

Form used to request employment verification letter.

Federal Work Study (FWS) Job Description

Form used to post available FWS positions. Please contact Federal Work Study Division Coordinator with questions.

Position Description

Form used to create, post, or modify an existing position on campus.

Position Requisition

Form used to initiate filling a vacancy or a new position.

Request and Condition for Reimbursement of Relocation Expenses Form

Form used to request reimbursement for relocation expenses (please see accompanying manual below).

SDSU Relocation Policy and Procedure Manual

Manual outlining policies and procedures for reimbursement of relocation expenses.

Staff Transaction Form

Form to appoint, reappoint, end, or modify an appointment for staff employees.

Student Employment Authorization Form (SEA) - Updated Apr 2013

Used by department timekeepers to appoint student employees into temporary positions.

Unit 11 Job Vacancy Announcement Powered by SurveyGizmo survey software.
Form to compose, submit, and post available positions within colleges for teaching associates, graduate assistants, and instructional student assistants.

Volunteer Identification Form

Form used to appoint volunteers.

Performance Evaluations

Confidential Employees

Form used to evaluate the work performance of confidential employees.

Management Personnel

Form used to evaluate the work performance of management level employees.

Performance Evaluation for Units 2, 5, 6, 7 & 9

Form used to evaluate the work performance of Unit 2, 5, 6, 7 & 9 employees.

Performance Evaluation for Unit 4

Form used to evaluate the work performance of Unit 4 employees.

Performance Evaluation for Unit 8

Form used to evaluate the work performance of Unit 8 employees.

Retired Annuitant Appointments
Guidelines related to retired annuitant appointments.

CalPERS Circular Letter 200-002-12

The purpose of this Circular Letter is to inform you of changes to the Public Employee's Retirement Law (PERL).

CSU HR Technical Letter: Post-Retirement Employment: CalPERS’ Retirees

This HR Letter should be reviewed in its entirety by staff responsible for making hiring decisions in the employment of CalPERS retirees.

Guide to CalPERS Employment After Retirement

The following contains general information regarding working after retirement. If you have any questions after reading the contents of this publication, contact CalPERS prior to accepting employment.

Human Resources Information Systems (HRIS)

PeopleSoft Access Request Form

Use this form to request or cancel PeopleSoft Access. Fill out the top portion of the form (Name, Red ID, E-mail, Phone and Justification). Also, at the bottom of the form please be sure to get the appropriate signatures. Send a copy of the document via fax (ext. 4-2841) to Human Resoures Information Systems (HRIS).

PeopleSoft Delete Cache Guide

This guide will walk you through the steps to delete cache from your computer, improving system performance.

PeopleSoft Employee Self Service Guide

This guide will walk you through the steps to access your personal information.

PeopleSoft Manager Self Service Guide

This guide will walk you through the steps to access your employee information.

PeopleSoft Password Guide

This guide will walk you through the steps to establish, change and retrieve a forgotten PeopleSoft password.

Payroll & Compensation

Attendance Summary - Updated May 2013

Used to report attendance: hours worked (hourly staff) or absences (salaried staff).

Attendance Summary (Alternate Work Schedule) - Updated May 2013

Used to report attendance: hours worked (hourly staff) or absences (salaried staff) if working an alternate work schedule.

Authorization for Extra Hours (Overtime Form) - Updated May 2013

Used to report extra hours worked either for payment or compensating time off.

CalPERS Retiree Deduction Authorization

Used by CalPERS retirees to authorize gift deductions from their retiree paycheck.

Direct Deposit Form

Used to enroll/change/cancel direct deposit.

Duplicate Wage & Tax Statement Request

Used by employees or Payroll staff to request duplicate W-2 Forms.

Employee Action Request (EAR)

Used to update employee name, address and/or withholding status.

Federal Work Study Time Card

Used by Federal Work Study students to report hours worked to their supervisors. Instructions included.

Foreign National Information Form (FNIF)

Used by foreign employees to determine tax residency status.

Report of Employee Schedule

Used to report an alternate schedule or a change to an employee's schedule.

Student Assistant Attendance Report - Updated May 2013

Used by department time keepers to report a summary of hours worked for a group of students.

Student Assistant Time Card - Updated May 2013

Used by students to report hours worked to their supervisors.

Student Employment Authorization Form (SEA) - Updated April 2013

Used by department timekeepers to appoint student employees into temporary positions.

Student Payroll Action Request (SPAR)

Used to update student employees’ name, address, and/or withholding status.

Wireless Device Authorization Form & Procedures
Effective January 1, 2012, the wireless device process is being handled through Accounts Payable.

Policies, Procedures & Guidelines

Employee Drug-Free Policy

SDSU policy adopted regarding illegal substance abuse.

Employee Nepotism Policy

SDSU policy adopted to implement CSU Nepotism Policy (HR 2004-18).

Employee Nepotism Form

To be completed when employee is supervised by a family member.

Employee Smoke-Free Policy

SDSU policy adopted to implement CSU Executive memorandum 02-108 in accordance with Education Code 89030 and 89031 (§1944.30).

Executive Order 1083

All faculty, staff and student employees are required to review and sign the CSU Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect Form (located at: http://hr.sdsu.edu/pdf/Policies/EO1083_Acknowledgement.pdf).

Every employee must submit the signed form to Payroll Services by March 1, 2013. Completed forms may be submitted in PDF format by emailing chr.payroll@mail.sdsu.edu, or in hardcopy via interoffice mail to: Payroll Services, EO 1083, MC 1625. All faculty, staff and student employees should be sure to maintain a copy of their signed form for their records.

The Office of Employee Relations and Compliance is designated to respond to any questions or concerns regarding this requirement, and may be contacted by calling (619) 594-6464.

Suspected Child Abuse Report

To be completed by Mandated Child Abuse Reporters Pursuant to Penal Code Section 11166.

Smoking in Designated Areas Policy (effective 8/22/2011)

SDSU policy adopted to implement Cal. Code Regs. Title 5 section 42356 and CSU Memorandum 200-26 and 2003-19 in accordance with the Education Code 89030 and 89031 and Cal. Govt Code sections 7596-7598.

Employee Violence-Free Policy

SDSU policy adopted regarding the security of faculty, staff, and students.

SDSU Relocation Policy (effective 5/1/2012)

SDSU policy adopted in accordance with CSU Human Resources Coded Memo HR 2012-02, Updated Moving and Relocation Policy and Updated CSU Internal Procedures Governing Moving and Relocation Expenses.

Request and Condition for Reimbursement of Relocation Expenses Form

SDSU Relocation Policy and Procedure Manual

Workers’ Compensation

Notice of Pre-Designation of Physician

For employees who would like to pre-designate a physician before a work-related injury/illness occurs.

Supervisor’s Report of Work-Related Accident/Illness Form

Form that the supervisor of an injured employee completes.

Supervisors Responsibilities Regarding Work Incurred Injuries (Check List)

Supervisors shall print out document and complete check list upon employee injury.

Workers’ Compensation Claim Form (DWC 1)

Form to be completed by an injured employee.

BENEFITS
Health Care

Affidavit of Parent-Child Relationship
Allows for the enrollment of a child (other than natural, adopted or step-child) in the CalPERS sponsored health programs.

Benefits Enrollment/Change Form
A worksheet for employees to designate their dental, medical and flexcash options (opting out of benefits).

Declaration of Health Care Coverage
A CalPERS-required form for enrolling into or opting out of benefits.

Delta Dental Claim Form
Used by employees if a Delta Dental provider does not bill directly for services.

HIPPA Authorization Form
Employee Authorization for Benefits staff to use and/or disclose personal health plan information.

VSP Out-of-Network Reimbursement Form
Vision reimbursement form for employees who utilized the services of a non-network doctor.

VSP Video Display Terminal (VDT) Confirmation Form
Vision form for employees who meet the job requirements for the VDT benefit that is given to a VSP Network doctor.

Flexible Benefits

Dependent Care/Health Care Claim Form
Used to establish a dependent and/or health care reimbursement account.

Dependent Care/Health Care Reimbursement Account Plans Enrollment Authorization
Enrollment form used to establish Health Care and/or Dependent Care reimbursement accounts.

Direct Deposit Form for Dependent Care/Health Care
For employees who wish to receive their Flexible Spending Accounts reimbursements by direct deposit.

FlexCash Program Enrollment Authorization
Forms used to “opt out” of medical and/or dental benefits.

Medical-Related Leaves

Leave of Absence Request Form
For employees who wish to request a leave of absence for medical, family medical leave, parental, pregnancy, military, education, personal or other leaves.

Survivor Protection Benefits

Life and AD&D Beneficiary Designation and Change Form
To designate or change the beneficiary of the employer-paid Life and AD&D benefit.

Retirement Plans

TSA Maximum Contribution Worksheet
For individuals who want to contribute more than the annual maximum and are age 50 or older and/or a 15-years of service.

Fee Waiver

Career Development Plan
To be completed by employees who are pursuing a degree program.

CSU $55 Application Fee Waiver
Allows for the waiver of the application fee to one CSU campus.

Dependent Fee Waiver Form
To be used when eligible dependents will be utilizing the employee’s fee waiver benefit.

Employee Fee Waiver Form
To be completed by employees who will be utilizing the fee waiver benefit.

DIRECTOR'S OFFICE

CSU Conflict of Interests Disclosure Categories
The list gives employees in designated positions a description of each category that is required to submit the Form 700 Statement of Economic Interest form annually.

Form 700 Statement of Economic Interest
Form 700 pamphlet includes instructions and forms for employees in designated positions to complete the form annually.

Political Reform Act 2008
A description of the Political Reform Act published by the Fair Political Practices Commission.

San Diego State University Designated Positions
List of Designated Positions associated with the Statement of Economic Interest. The list is established through the Chancellor’s Office.

EMPLOYEE & ORGANIZATION DEVELOPMENT

President’s Management Development Application Form
Application form that is submitted in August.

EMPLOYMENT & CLASSIFICATION
Compensation

Discretionary Pay Increase Unit 4 Recommendation
Form used to request a discretionary pay increase for Unit 4 employees.

In-Range Progression Guidelines and Forms
Form used to submit an in–range progression request.

Employment

Confidential Employees Human Resources Program Guidelines
Guidelines pertaining to the confidential classifications.

Employment Verification
Form used to request employment verification letter.

Federal Work Study (FWS) Job Description
Form used to post available FWS positions. Please contact Federal Work Study Division Coordinator with questions.

Position Description
Form used to create, post, or modify an existing position on campus.

Position Requisition
Form used to initiate filling a vacancy or a new position.

Request and Condition for Reimbursement of Relocation Expenses Form
Form used to request reimbursement for relocation expenses (please see accompanying manual below).

SDSU Relocation Policy and Procedure Manual
Manual outlining policies and procedures for reimbursement of relocation expenses.

Staff Transaction Form
Form to appoint, reappoint, end, or modify an appointment for staff employees.

Student Employment Authorization Form (SEA) - Updated Apr 2013
Used by department timekeepers to appoint student employees into temporary positions.

Unit 11 Job Vacancy Announcement Powered by SurveyGizmo survey software.
Form to compose, submit, and post available positions within colleges for teaching associates, graduate assistants, and instructional student assistants.

Volunteer Identification Form
Form used to appoint volunteers.

Performance Evaluations

Confidential Employees
Form used to evaluate the work performance of confidential employees.

Management Personnel
Form used to evaluate the work performance of management level employees.

Performance Evaluation for Units 2, 5, 6, 7 & 9
Form used to evaluate the work performance of Unit 2, 5, 6, 7 & 9 employees.

Performance Evaluation for Unit 4
Form used to evaluate the work performance of Unit 4 employees.

Performance Evaluation for Unit 8
Form used to evaluate the work performance of Unit 8 employees.

Retired Annuitant Appointments
Guidelines related to retired annuitant appointments.

CalPERS Circular Letter 200-002-12
The purpose of this Circular Letter is to inform you of changes to the Public Employee's Retirement Law (PERL).

CSU HR Technical Letter: Post-Retirement Employment: CalPERS’ Retirees
This HR Letter should be reviewed in its entirety by staff responsible for making hiring decisions in the employment of CalPERS retirees.

Guide to CalPERS Employment After Retirement
The following contains general information regarding working after retirement. If you have any questions after reading the contents of this publication, contact CalPERS prior to accepting employment.

HUMAN RESOURCES INFORMATION SYSTEMS (HRIS)

PeopleSoft Access Request Form
Use this form to request or cancel PeopleSoft Access. Fill out the top portion of the form (Name, Red ID, E-mail, Phone and Justification). Also, at the bottom of the form please be sure to get the appropriate signatures. Send a copy of the document via fax (ext. 4-2841) to Human Resoures Information Systems (HRIS).

PeopleSoft Delete Cache Guide
This guide will walk you through the steps to delete cache from your computer, improving system performance.

PeopleSoft Employee Self Service Guide
This guide will walk you through the steps to access your personal information.

PeopleSoft Manager Self Service Guide
This guide will walk you through the steps to access your employee information.

PeopleSoft Password Guide
This guide will walk you through the steps to establish, change and retrieve a forgotten PeopleSoft password.

PAYROLL & COMPENSATION

Attendance Summary - Updated May 2013
Used to report attendance: hours worked (hourly staff) or absences (salaried staff).

Attendance Summary (Alternate Work Schedule) - Updated May 2013
Used to report attendance: hours worked (hourly staff) or absences (salaried staff) if working an alternate work schedule.

Authorization for Extra Hours (Overtime Form) - Updated May 2013
Used to report extra hours worked either for payment or compensating time off.

CalPERS Retiree Deduction Authorization
Used by CalPERS retirees to authorize gift deductions from their retiree paycheck.

Direct Deposit Form
Used to enroll/change/cancel direct deposit.

Duplicate Wage & Tax Statement Request
Used by employees or Payroll staff to request duplicate W-2 Forms.

Employee Action Request (EAR)
Used to update employee name, address and/or withholding status.

Federal Work Study Time Card
Used by Federal Work Study students to report hours worked to their supervisors. Instructions included.

Foreign National Information Form (FNIF)
Used by foreign employees to determine tax residency status.

Report of Employee Schedule
Used to report an alternate schedule or a change to an employee's schedule.

Student Assistant Attendance Report - Updated May 2013
Used by department time keepers to report a summary of hours worked for a group of students.

Student Assistant Time Card - Updated May 2013
Used by students to report hours worked to their supervisors.

Student Employment Authorization Form (SEA) - Updated Apr 2013
Used by department timekeepers to appoint student employees into temporary positions.

Student Payroll Action Request (SPAR)
Used to update student employees’ name, address, and/or withholding status.

Wireless Device Authorization Form & Procedures
Effective January 1, 2012, the wireless device process is being handled through Accounts Payable.

POLICIES, PROCEDURES & GUIDELINES

Employee Drug-Free Policy
SDSU policy adopted regarding illegal substance abuse.

Employee Nepotism Policy
SDSU policy adopted to implement CSU Nepotism Policy (HR 2004-18).

Employee Nepotism Form
To be completed when employee is supervised by a family member.

Employee Smoke-Free Policy
SDSU policy adopted to implement CSU Executive memorandum 02-108 in accordance with Education Code 89030 and 89031 (§1944.30).

Executive Order 1083
All faculty, staff and student employees are required to review and sign the CSU Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect Form (located at: http://hr.sdsu.edu/pdf/Policies/EO1083_Acknowledgement.pdf).

Every employee must submit the signed form to Payroll Services by March 1, 2013. Completed forms may be submitted in PDF format by emailing chr.payroll@mail.sdsu.edu, or in hardcopy via interoffice mail to: Payroll Services, EO 1083, MC 1625. All faculty, staff and student employees should be sure to maintain a copy of their signed form for their records.

The Office of Employee Relations and Compliance is designated to respond to any questions or concerns regarding this requirement, and may be contacted by calling (619) 594-6464.

Suspected Child Abuse Report
To be completed by Mandated Child Abuse Reporters Pursuant to Penal Code Section 11166.

Smoking in Designated Areas Policy (effective 8/22/2011)
SDSU policy adopted to implement Cal. Code Regs. Title 5 section 42356 and CSU Memorandum 200-26 and 2003-19 in accordance with the Education Code 89030 and 89031 and Cal. Govt Code sections 7596-7598.

Employee Violence-Free Policy
SDSU policy adopted regarding the security of faculty, staff, and students.

SDSU Relocation Policy (effective 5/1/2012)
SDSU policy adopted in accordance with CSU Human Resources Coded Memo HR 2012-02, Updated Moving and Relocation Policy and Updated CSU Internal Procedures Governing Moving and Relocation Expenses.