View UC Santa Cruz Home Page
View Staff HR Home PageView Staff HR Directory & SevicesView Staff HR Forms LibraryPolicies & ContractsStaff HR Procedures
View the SHR A-Z Index View the SHR Glossary
Forms by Topic ...
Benefits
Changes in Appointment
Compensation/Classification
Complaint Resolution
Corrective Action
Employment
Layoff/Separation
Leaves/Furlough
Performance Management
Professional Development
Recruitment
Time & Attendance
Forms Listed by ...
Form Title

Other Resources ...
Academic Personnel Office
Equal Employment Opportunity/ Affirmative Action Office

Campus Ombuds
PPS
Title IX, Sexual Harassment
UCOP Home
UCSC Home
UCSC Faculty/Staff Directory
UCSC Staff Toolkit

Staff Human Resources
UC Santa Cruz
1156 High Street
Santa Cruz, CA 95064
Phone: 831-459-2009

Office Location: [Directions]
1201 Shaffer Road
Santa Cruz, CA 95060

View the SHR A-Z Index View the SHR Glossary © UC Santa Cruz
Terms and Conditions of Use
Maintained by shrweb@ucsc.edu
Last Revised: 03/19/2007

Staff HR Forms Library

Benefits Forms

Benefits Bridge Insurance Continuation - Unit 18 shr-1060.pdf
  UCSC Insurance Continuation Election Form, instructions, and rates for Unit 18 employees on Benefits Bridge.  
COBRA Rates (Link)
  COBRA insurance continuation rates.
 
Furlough Insurance Continuation shr-1010.pdf
  UCSC Insurance Continuation Election Form, instructions, and rates for employees on furlough.  
Leave Without Pay Insurance Continuation shr-1030.pdf
  UCSC Insurance Continuation Election Form, instructions, and rates for employees on leave without pay.  
UC Benefits Forms (Link)
  University of California At Your Service provides benefits forms & publications.  
Unemployment Insurance Termination Report ucop-1062.pdf
  Unemployment Insurance Termination Report to be completed by the department(s) for all separating employees.  
University of California Retirement Plan (UCRP) Waiver and Factsheet (Link)
  UCRP Waiver and Release Form, including guidelines for reemployment after retirement.