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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: 10/29/2009

Staff HR Forms Library

Changes-in-Appointment Forms

Background Investigation No Longer Interested (NLI) Form shr-1490.pdf
 

Used to notify the Department Of Justice that subsequent conviction information is no longer required for an employee/volunteer who previously completed a criminal history background check.

 
Background Investigation Request (BIR) shr-1480.pdf
 

One of the two forms required when initiating a criminal history background check on a potential or current employee who has accepted a critical position. Must be used in conjunction with the Live Scan Service Request)

 
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.
 
Contract Samples - MSP and PSS shr-1290.pdf
  Sample contracts for MSP and PSS employees.
 
Furlough Insurance Continuation shr-1010.pdf
  UCSC Insurance Continuation Election Form, instructions, and rates for employees on furlough.  
Furlough Notice shr-1070.doc
  Template for notice of furlough.  
Layoff Notice Template - Indefinite (99) shr-1520.doc
  To inform an employee not covered under a collective bargaining agreement of their layoff.  
Layoff Notice Template - Indefinite (CX) shr-1528.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (EX) shr-1544.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (HX) shr-1536.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (K7)

shr-1548.doc

  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (NX) shr-1552.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (PA) shr-1556.doc
 

To inform an employee of an indefinite layoff or reduction in time.

 
Layoff Notice Template- Indefinite (RX/TX) shr-1532.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Indefinite (SX) shr-1540.doc
  To inform an employee of an indefinite layoff or reduction in time.  
Layoff Notice Template - Temporary Layoff (limited) shr-1526.doc
  To inform a limited appointment employee not covered under a collective bargaining unit of their temporary layoff.  
Layoff Notice Template - Probationary (99, CX, NX, and HX) shr-1524.doc
  To inform a probationary employee (99, CX, NX, and HX) of an indefinate layoff.  
Layoff Notice Template - Temporary Layoff (all staff) shr-1522.doc
 

To inform employees of their temporary layoff.

 
Layoff Worksheet c17.pdf
  Layoff Worksheet  
Leave Without Pay Insurance Continuation shr-1030.pdf
  UCSC Insurance Continuation Election Form, instructions, and rates for employees on leave without pay.  
Live Scan Service Request shr-1470.pdf
 

One of the two forms required when initiating a criminal history background check on a potential or current employee who has accepted a critical position. Must be used in conjunction with the Background Investigation Request (BIR).

 
New Employee Information shr-1950.pdf
  This sheet contains general employment information for new employees.  
New Employee Service Team Checklist shr-1960.pdf
  A tool for Service Teams for the On-Boarding process.  
Supervisor Checklist for New Employees shr-1962.pdf
  This document is being provided to the supervisor and/or designee to assist in the orientation process of a new employee..  
Personnel File Access Request Form shr-1360.pdf
  Used by current and former staff employees to request access to their personnel file from Staff Human Resources. Requests for files from service centers must be made directly to the service center. Academic employees should contact AHR.  
Proof of Service Form shr-1370.pdf
  Fill out and attach with original and copies when proof of service or statement of delivery or mailing is required. Copies to appropriate files. (e.g., Notice of Intent)  
START 2008-2010 Contract shr-2022.doc
  The Staff and Academic Reduction in Time (START) Program Contract is to be used by eligible UCSC employees requesting participation in the 2008-2010 START Program. For more information, see Staff Academic Reduction in Time (START) Program.  
START 2008-2010 Contract Amendment shr-2021.doc
  The Staff and Academic Reduction in Time (START) Program Contract Amendment is to be used by UCSC employees participating in the 2008-2010 START Program, in order to request a change to the original START Program Contract. For more information, see Staff Academic Reduction in Time (START) Program.  
Supplement to Military Pay Worksheet (Link)
  Required when employees are called to active military duty while employed by the University; form helps determine if employee is eligible for military pay according to University policy and implementing guidelines. For more information, see Supplement to Military Pay Policies (UCOP).  
Termination - Sample Notice shr-1430.doc
  See Staff HR Procedures - Other separations and PPSM 64 or PPSM 65 or appropriate collective bargaining agreement.  
Termination - Sample Notice of Intent shr-1420.doc
  Written notice of intent to terminate is required prior to termination. See Staff HR Procedures - Other separations and PPSM 64 or PPSM 65 or appropriate collective bargaining agreement.  
Unemployment Insurance Termination Report ucop-1062.pdf
  Unemployment Insurance Termination Report to be completed by the department(s) for all separating employees.  

Staff HR Procedures

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