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HSU Forms

Employee

Form Number Title/Detailssort icon Department Direct Link To Form
Workers' Compensation for Students Human Resources
Work Request Form Facilities Management
Whistleblower Complaint Form Human Resources
W-4 W-4 - Employee's Witholding Allowance Certificate Human Resources

http://www.irs.gov/pub/irs-pdf/fw4.pdf

W-2 (replacement request) Human Resources

http://www.sco.ca.gov/ppsd_empinfo_dpw-2.html

Voluntary Self-Identification For Applicants Human Resources
Unit 4 - APC (Academic Professionals of California) - Annual Employee Evaluation Human Resources
TRiO UB Resident Mentor Application 2015 Sponsored Programs Foundation
Travel Expense Claim (Effective 1/1/16) Financial Services

http://www2.humboldt.edu/risksafety/Travel

Student Wage Schedule Human Resources
BS-FS-024A Student Award Request Form Financial Services
PR 19 Student Assistant Time Voucher Payroll

http://www2.humboldt.edu/payroll/node/57

Student Assistant Performance Evaluation Human Resources
SSA-1945 Statement Concerning Your Employment in a Job Not Covered by Social Security Human Resources
STD 274 State Driver Accident Review Contracts, Procurement and Risk Management

http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std274.pdf

Staff Evaluation Forms Human Resources

http://www.humboldt.edu/hsuhr/employee/evaluation/index.html

Sponsored Programs Foundation (SPF) Benefits for Eligible Employees Sponsored Programs Foundation
SPF: Title III and V Eligible Institution, Waiver of the Non-Federal Share Matching Requirements Sponsored Programs Foundation
SPF Volunteer Form to cover worker's comp Sponsored Programs Foundation
SPF voluntary 403 (b) salary reduction agreement Sponsored Programs Foundation
SPF Travel Reimbursement Instruction Guide Sponsored Programs Foundation
SPF Travel Expense Claim Sponsored Programs Foundation
SPF Summer Student Time Sheet 2016 Sponsored Programs Foundation
SPF Student Timesheet 2016 (NEW) Sponsored Programs Foundation
SPF Student Timesheet 2015 (NEW) Sponsored Programs Foundation
SPF Student Timesheet 2015 Sponsored Programs Foundation
SPF Student Funding Opportunities: How You Can Help Them Find Support Sponsored Programs Foundation
SPF Special Lecturer/Honorarium & Non-Student Stipend Form Sponsored Programs Foundation
SPF Separating Employee Clearance Form Sponsored Programs Foundation
SPF Request for Release Time Form: Appendix A Sponsored Programs Foundation
SPF Purchasing Policy Sponsored Programs Foundation
SPF Purchase Request Form Sponsored Programs Foundation
SPF Predesignation of Personal Physician Sponsored Programs Foundation
SPF Pre-Appointment Request for Background Check Sponsored Programs Foundation
SPF Position Description Sponsored Programs Foundation
SPF Personnel Policy Summary Sponsored Programs Foundation
SPF Personnel Policy Summary Sponsored Programs Foundation
SPF Personnel Policy Summary Sponsored Programs Foundation
SPF Personnel Manual Sponsored Programs Foundation
SPF Payroll, Benefits, and HR Directory of Services Sponsored Programs Foundation
SPF Payroll Schedule 2016 Sponsored Programs Foundation
SPF Payroll Schedule 2015 Sponsored Programs Foundation
SPF Payroll Schedule 2014 Sponsored Programs Foundation
SPF Overview of the Reasonable Accomodation Process Sponsored Programs Foundation
SPF NSF Funding Guide Sponsored Programs Foundation
SPF Non-Student Timesheet 2016 (NEW) Sponsored Programs Foundation
SPF Non-Student Timesheet 2015 Sponsored Programs Foundation
SPF Multiple Projects Appointment Form Attachment Sponsored Programs Foundation
SPF Monthly Absence Report Sponsored Programs Foundation
SPF MEMO: New Sick Leave Law for California Employees Sponsored Programs Foundation
SPF Lost Receipt Form Sponsored Programs Foundation
SPF Level of Effort Certification 2016 (NEW) Sponsored Programs Foundation
SPF Level of Effort Certification 2015 Sponsored Programs Foundation
SPF Job Duty Evaluation Checklist Sponsored Programs Foundation
SPF International Travel Insurance Sponsored Programs Foundation
SPF Institutional Routing and Authorization Form Sponsored Programs Foundation
SPF Indirect Rate Policy Sponsored Programs Foundation
SPF Health Insurance Marketplace Employee Notice Sponsored Programs Foundation
SPF Guidelines for Evaluating Impairments Sponsored Programs Foundation
SPF Guidelines - Voluntary 403 (b) plan Sponsored Programs Foundation
SPF Financial Statements Audit 2011 Sponsored Programs Foundation
SPF Employment - SBDC Office Manager Sponsored Programs Foundation
SPF Employment - Research Associate (Post-Doc) Position Sponsored Programs Foundation
SPF Employment - Business Development & Marketing Specialist Sponsored Programs Foundation
SPF Discrimination Complaint Form Sponsored Programs Foundation
SPF Confidentiality Form Sponsored Programs Foundation
SPF Close Relative Disclosure Form Sponsored Programs Foundation
SPF Budget Template Sponsored Programs Foundation
SPF Budget Guidebook Sponsored Programs Foundation
SPF Authorization to Release Medical Records Sponsored Programs Foundation
SPF Audited Financial Statements, period ending June 30, 2013 Sponsored Programs Foundation
SPF Audited Financial Statements, period ending June 30, 2012 Sponsored Programs Foundation
SPF Appointment Document Sponsored Programs Foundation
SPF Alistair & Judith McCrone Graduate Fellowship Award Sponsored Programs Foundation
SPF Administrative Manual Sponsored Programs Foundation
SPF Accomodation Request Form Sponsored Programs Foundation
SPF 700-U Form (Conflict of Interest) Sponsored Programs Foundation
SPF 403(b) defined contribution (DC) plan summary Sponsored Programs Foundation
PR 43 Special Consultant Time Voucher Payroll
Special Consultant Request Instructions Human Resources
Special Consultant Request Human Resources
SS-5 Social Security: Replacement card/name change application. Human Resources

http://www.ssa.gov/online/ss-5.html

n/a Signature Authority Form Contracts, Procurement and Risk Management
Separating Management Clearance Form Human Resources
Separating Employee Clearance Form Human Resources
Secure Destruction E-Waste Collection and Chain of Custody Form Financial Services
RM - Field Trip Sign Out Release Agreement Contracts, Procurement and Risk Management
RM - Field Trip Participant Roster Contracts, Procurement and Risk Management
001 Reservation Request for the Native American Forum (BSS162) Center for Indian Community Development
Required Notification for Employees Not Covered by Social Security (SSA-1945 Form) Human Resources
Request For Record Information University Police Department
Request for International Travel Financial Services

http://www.humboldt.edu/risksafety/Travel

Request for Authorization to Travel (Domestic travel) Financial Services

http://www.humboldt.edu/risksafety/Travel

Form 109 Report of Separation for Staff - (Electronic) Human Resources

https://accountcenter.humboldt.edu:4443/p/r/f?p=239

HSU 71 Report of Missing Property Form Financial Services
Form 104 Report of Appointment for Staff Human Resources

https://accountcenter.humboldt.edu:4443/p/r/f?p=141:DOC1

Rental Vehicle Request Form Facilities Management
Rehired Annuitant Certification Human Resources
Reference Check Information for Recommended Candidate Academic Personnel Services and Human Resources
Receipting Instruction for Deposits at the Cashier’s Office Financial Services

http://www2.humboldt.edu/businessservices/node/54

ProCard Lost Receipt Memo Contracts, Procurement and Risk Management
Position Description/Classification Guide Human Resources

http://www.humboldt.edu/hsuhr/employee/position/description.html

Position Description Form Human Resources
Position Change Form University Budget Office
Pool Vehicle Request Form Facilities Management
Petty Cash form Financial Services
Performance Pay Salary Increase Recommendation - Unit 4 Human Resources

http://www.humboldt.edu/hsuhr/employee/information/unit4.html

PCI Application Financial Services

http://www2.humboldt.edu/policy/PEMP11-03Policy-Compliance-Payment-Card-...

Payment Request Form Financial Services
Password Group Setup form (Aging) Information Technology Services
Outgoing International Wire Request Financial Services
13 OSA Nomination Information & Questions Enrollment Management & Student Affairs
ORSP Newsletter Spring 2012 Sponsored Programs Foundation
ORECD Org Chart Sponsored Programs Foundation
Onboarding Checklist: Vice President Human Resources
Onboarding Checklist: Payroll Human Resources
Onboarding Checklist: Hiring Authority Human Resources
Onboarding Checklist: Employee Human Resources
Onboarding Checklist: Department Contact Human Resources
Onboarding Checklist: Complete Checklist Document (All Roles) Human Resources
Onboarding Checklist: Buddy Human Resources
Onboarding Checklist: Appropriate Administrator and/or Lead Human Resources
Onboarding Checklist: Academic Personnel Services & Human Resources (APSHR) Human Resources
STD 270 Motor Vehicle Accident Report Contracts, Procurement and Risk Management

http://www.documents.dgs.ca.gov/dgs/fmc/pdf/std270.pdf

Model Release (4 per page) Marketing and Communications
Model Release Marketing and Communications
Manager's Digital Resources Checklist for Separating Employees Information Technology Services
Lost Receipt Memo Financial Services
Letterhead Order Form Marketing and Communications

https://humboldt.webdeskprint.com/PSP/app/PSP_Start.asp

IRB Registration Sponsored Programs Foundation
IRB Policy for the Protection of Human Subjects in Research Sponsored Programs Foundation
IRB Implementaion of the Policy for Protection of Human Subjects in Research Sponsored Programs Foundation
IRB Full Board Review SCHEDULE 15-16 Sponsored Programs Foundation
IRB Consent Checklist Sponsored Programs Foundation
IRB Application for Review Sponsored Programs Foundation
PR 8 Intermittent Hourly Time Voucher Payroll
Instructions to Complete Digital Signature on Position Change Form Human Resources
PR 8a Instructional Student Assistant Work Study Time Voucher Payroll

http://www2.humboldt.edu/payroll/node/57

PR 55 Informal Leave Without Pay Payroll
In-Range Progression Request Form Human Resources
HSU Wireless Device Reimbursement Rates Financial Services
HSU Volunteer Form Processing Instructions Human Resources
HSU Volunteer Form Human Resources
HSU SPF Benefit Rates July 1, 2015 Sponsored Programs Foundation
HSU Overview of Reasonable Accommodation Human Resources
HSU Letterhead Template (MS Word) Marketing and Communications

http://www2.humboldt.edu/marcom/campusResources.php?section=templates

HSU Job Duty Evaluation Checklist Human Resources
HSU Guidelines for Evaluating Impairments Human Resources
HSU Green and Gold Calendar for 2012-2013 Payroll Department
HSU Green and Gold Calendar for 2011-2012 Human Resources
HSU Green and Gold Calendar for 2010-2011 Human Resources
HSU Background Check Packages Academic Personnel Services and Human Resources
HSU Authorization to Release Medical Records Human Resources
HSU Authorization for Business-Related Wireless Device Financial Services
HSU Accommodation Request Form Human Resources
HSU - Release of Liability Contracts, Procurement and Risk Management
Housing & Dining Services Separating Employee Clearance Form Human Resources
STD 236 Hotel/Motel Transient Tax Waiver Financial Services
Grant Furlough Exemption Form Human Resources
APS Form 570 Form 570: Substitute Faculty Assignment Academic Personnel Services
Form 109 Report of Separation Form Submission Guide Human Resources
Form 109 Report of Separation Approval Guide Human Resources
Fee Waiver Application-Self Academic Personnel Services and Human Resources

https://accountcenter.humboldt.edu:4443/p/r/f?p=137:11

Fee Waiver Application-Dependent Academic Personnel Services and Human Resources

https://accountcenter.humboldt.edu:4443/p/r/f?p=137:10

Fee Waiver - Fees Waived (Employee) Academic Personnel Services and Human Resources
Fee Waiver - Fees Waived (Dependent) Academic Personnel Services and Human Resources
Every Step Counts! Campus Map Human Resources
PR 11 Evening and Night Shift Differential Time Voucher Payroll
Establish Petty Cash or Change Fund Form Financial Services
EO 1097 Student Affirmative Action Complaints Actions Resources Table Human Resources
Envelope Order Form Marketing and Communications

https://humboldt.webdeskprint.com/PSP/app/PSP_Start.asp

6 EMSA Position Justification and Budget Verification Enrollment Management & Student Affairs
7 EMSA Position Justification & Budget Verification (PJBV) Instructions & Examples Enrollment Management & Student Affairs
1 EMSA Leave Request Memo Enrollment Management & Student Affairs
Employee/Student Verification of University Employment Facilities Management
105 EMPLOYEE INFORMATION FORM (EIF) Human Resources
Employee Fee Waiver-Frequently Asked Questions Human Resources
Employee Fee Waiver - Frequently Asked Questions Academic Personnel Services and Human Resources
I-9 Employee Eligibility Verification Human Resources

http://www.uscis.gov/files/form/i-9.pdf

Employee Assistance Program (EAP) Human Resources
STD. 686 Employee Action Request (EAR) Human Resources
EHOS Hot Work Permit Program Environmental Health and Occupational Safety
EHOS Ergonomics Program Human Resources
STD 436 DUPLICATE WAGE AND TAX STATEMENT REQUEST Payroll
Discrimination Complaint Resources Human Resources
Direct Pay form Financial Services
STD-699 Direct Deposit Form Human Resources
Direct Deposit for Employee Reimbursements Financial Services
Designated Positions Human Resources
HR 2005-26 CSU Volunteer Policy Human Resources
CSU Volunteer Identification Form Facilities Management

http://www.humboldt.edu/forms/node/350

CSU Family Medical Leave (FML) Human Resources
CSU Employee Benefits Summaries - Faculty (Unit 3) Human Resources
CSC Campus Change Report 2010-2011 Change Steering Committee
003G Controlled IT Spaces Visitor Log Information Technology Services
003D Controlled IT Spaces Access Control List Information Technology Services
003C Controlled IT Spaces Access Authorization Form Information Technology Services
Confidentiality Statement for Academic Professionals (Unit 4) Human Resources
Confidentiality Agreement for Employees, Consultants, and Independent Contractors Human Resources
Coach Performance Evaluation Form Academic Personnel Services
Check Request form Financial Services
Certified Wipe Media Label Information Technology Services
PR 64 Casual Worker Time Voucher Payroll
Career Development Plan Human Resources

https://accountcenter.humboldt.edu:4443/p/r/f?p=138:3

Business Card Order Form Marketing and Communications

https://humboldt.webdeskprint.com/PSP/app/PSP_Start.asp

Background Checks for HSU Sponsored Programs Foundation Sponsored Programs Foundation
STD 261 Authorization to Use Privately Owned Vehicle Financial Services
Authorization for Off-Campus Use of Equipment Form Financial Services
Application Procedures for Leave of Absence without Pay Human Resources
107 Application for Leave of Absence Human Resources

http://humboldt.edu/hsuhr

APS Application for Academic Employment Academic Personnel Services
8 Alcohol Approval Request Enrollment Management & Student Affairs
APS Form 510 Advice of Separation: Lecturer, FERP, TA & GA Academic Personnel Services

http://www.humboldt.edu/aps

APS Form 610 Advice of Separation: Instructional Student Assistants Academic Personnel Services

http://www.humboldt.edu/aps

APS Form 515 Advice of Separation: Coaches, Counselors (SSP-AR & Interns), Librarians Academic Personnel Services

http://www.humboldt.edu/aps

Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect (EO 1083) Human Resources
Accident Report (Non-Vehicle) Contracts, Procurement and Risk Management

http://www.documents.dgs.ca.gov/orim/std268s.pdf

Access Request Form (ARF) ITS Administrative Support
PR 54 Absence Excess Hours Holiday Worked Payroll
3rd Annual PI Celebration! Sponsored Programs Foundation
Job Submission Form Marketing and Communications

https://humboldt.webdeskprint.com/PSP/app/PSP_Start.asp