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  • Human Resources Forms

New Hire Forms

Download the New Hire Paperwork Checklist First!

Description of Form or Document Explanation
I-9 Verify Required Forms of Identification Effective 3-8-13—Expires 3-31-16
W-4 For the Current Year
Oath of Office Form 2015-82
Policy Acknowledgement Form

Employee Conduct/Behavior Expectation Policies		 Revised 05/12
Workweek Designation Fair Labor Standards Act-FLSA Revised 12-04
At-Will Status Acknowledgement
Management | Confidential		 Management / Confidential Only
Deputy Oath For Sworn Job Classifications - County Clerk Form 13
Appointment Above 1st Step or Bottom of Band Memo When Applicable
Personnel Action Form - PAF Report is generated from PeopleSoft
LIVESCAN Service - Fingerprint form for Sheriff's Department (Visual Sample Only) SCOE has all of the form templates
Union Deduction Form Revised 7/12

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Risk Management

Description of Form or Document Explanation
Medical Provider Network Brochure Revised 12-01-09 Thirteen Page Brochure From RMD
Acknowledgement Form Confirming Receipt of WC and MPN Brochures Revised 02-23-2012
DWC-Time to Hire Pamphlet 3-1-07
Select appropriate Department from drop down list on the right before clicking link

POST Offer/ Pre-Placement Screening Passport - Kaiser(Word Document)
POST-Offer Medical Testing Program Department Instructions/Overview Revised June 2012
Family Medical Leave of Absence Policy January 2009

Certification of Health Care Provider for Family Leave

 10/28/11
Certification for Serious Injury or Illness of a Covered Service Member for Military Family Leave January 2009
Certification of Qualifying Exigency Military Family Leave January 2009
Your Rights and Responsibilities under the FMLA January 2009

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Benefits - Full Time Employee

Description of Form or Document Explanation
Universal Enrollment / Change Form To add/change dependent information
Marriage/Birth Certificates For Dependents being enrolled on any health plan (med, den, vis).
Life Insurance Enrollment Form To indicate life insurance beneficiaries.
Evidence of Insurability - For Additional Life Insurance over $100,000 Employee to fax this form directly to ING.
Deferred Compensation - Enrollment packets from Hartford. These packets are available from the CEO-Risk Management Division Employee Benefits Website. Required for PO1,PO2,PO3,PO6,PO8. Other BU Optional. The Forms Are In The Back Of Packet.
Insurance Waiver & Proof of Other Insurance Use to waive benefits.

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Benefits - Part Time Employee

PARS - Is an Alternative Retirement System for part time, temporary or seasonal employees

Description of Form or Document Explanation
PARS Designation of Beneficiary Form Revised 3-05
PARS Plan Information Sheet Revised 2-13-07
PARS Plan Summary Revised 9-04
PARS SSA-1945 Cover Letter Two (2) Copies to the Chief Executive Office
PARS SSA-1945 Notification Form Two (2) Copies to the Chief Executive Office
PARS Government Pension Offset Information Sheet Revised 8-04
PARS Windfall Elimination Provision Information Sheet Revised 3-04

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Extra-Help Retired County Employee

Rehiring a Retiree as a Part Time Employee or PSC

Description of Form or Document Explanation
Rehiring a Retired County Employee Checklist Revised 2/27/13

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Retirement

Description of Form or Document Explanation
Retirement Member Enrollment Form Revised 03/21/13 Attach Copy of Birth Certificate
Notice to Prospective Members FORM 415 Revised 01-13
Beneficiary Designation Form Instructions for Active Members New added 7-08
Beneficiary Designation Form Revised 5-09
Termination of Employment Revised 07-08

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Exit Interview

Description of Form or Document Explanation
Exit Interview Process and Form Revised 04/06/07

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Recruitment

Description of Form or Document Explanation
Disqualification Language Revised 07/12/2012
Qualifying Rating Sheet Revised 07/12/2012
Qualifying Nameplates Revised 07/12/2012

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Other Forms

Description of Form or Document Explanation
Voluntary Time Bank Procedures Final Version distributed January 2008
Employee Donation of Time Form Revised 7/11
Donated Time Eligibility form Revised 9/07
DOT Employee Clinic Passport Revised 5/12
For Cause Testing Employee Clinic Passport Revised 5/12
Ethics Complaint Form Revised 6/11
Retiree Exempt Form Revised 7/12

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