Forms for City Employees

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• Absence Analysis Calendar, 2009: MS Word / Adobe PDF
• Absence Analysis Calendar, 2008: MS Word / Adobe PDF
• Absence Analysis Calendar, 2007: MS Word / Adobe PDF
• Accident to Employee Under Worker's Compensation Act, Report of (EB-49, R 10/06): MS Word
  ( Click here  for instructions regarding the EB-49 form; R 10/05)
• Budget Administration Forms (must have MINT access): click here
• Classification Related Forms and Guidelines: click here
• Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
• Daily Report "Time Off" Overtime Worked or Taken Off (CBP-171): MS Word / Adobe PDF
• Dental Enrollment Form: MS Word / Adobe PDF
  • Dental Insurance Information: click here
• Disciplinary Appeals, Requirements for: Adobe PDF
• Disciplinary Reduction (Demotion) Notice (CS-113, R 3/07): MS Word / Adobe PDF
• Discharge Notice (CS-81, R 3/07): MS Word / Adobe PDF
• Employee Complaint Form ( for use by City employees) (R 12/04) : Adobe PDF
• Engineering Merit Increment Application (R 4/07): MS Word / Adobe PDF
• Equal Rights Commission Complaint Form: Adobe PDF
• Expenses Incurred, Statement of (CBP-211, R 10/05): MS Word
• Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
• Flexible Choices Program Forms and Information: click here
• FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
• FMLA Related Forms:
  • Medical Certification Under the FMLA (R 9/03): MS Word / Adobe PDF
  • Request for Leave Under the FMLA (R 6/07): MS Word / Adobe PDF
  • Coming soon: Request for Additional Period of Health and Dental Insurance Under the FMLA
• Funeral Leave, Application for (CBP-155, R 10/05): MS Word / Adobe PDF
• Grievance Forms:
  • Grievance Initiation (CS-50, R 11/06): MS Word / Adobe PDF
  • Grievance Disposition (CS-51, R 7/07): MS Word / Adobe PDF
  • Grievance Appeal (CS-52, R 7/07): MS Word / Adobe PDF
  • Grievance Form, Fire Department (CC-233, R. 11/07): MS Word / Adobe PDF
  • Grievance Form, Fire Department, Bureau of Construction and Maintenance (CC-234, R. 11/07): MS Word / Adobe PDF
• Grievance Procedure for Management and Non-Represented City Employees:  Adobe PDF 
• Health Enrollment Form: Adobe PDF
  • Click here for current Health Insurance Information.
• Hiring Checklist (R 5/07): Adobe PDF
  • Safety Orientation Checklist: Adobe PDF
• Job Description (CS-25, R 1/07): click here
• Job Performance Improvement Plan, Employee: MS Word / Adobe PDF
• Jury Duty, Application for (C-139RS, R 4/05): MS Word / Adobe PDF
• Leave of Absence, Request for (CBP-129, R 3/07): MS Word / Adobe PDF
• Long-Term Disability Forms and Information: click here
• Management Performance Planning and Review Forms: click here
• Military Training Leave, Riot or Civil Disturbance Duty, Request for (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF
• New Employee Orientation Forms & Info: click here (you must have Intranet access)
• Office Support Continuing Education Incentive Program Application (ER-300, R 5/06): MS Word / Adobe PDF
• Payroll Certification (CS-90) - MUST be printed on yellow paper: PDF format
• Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
• Personnel Requisition/Request to Fill (BMD-1): MS Excel
• Probationary Service, Report on (CS-58, R 4/08): MS Word / Adobe PDF
• Procurement Forms (must have MINT access) : click here
• Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01): MS Word / Adobe PDF
• Reinstatement, Request for (R 10/06): MS Word / Adobe PDF
• Residency Related Forms and Information:
  • City Residency Requirement: Adobe PDF
  • Finding of Necessity: Adobe PDF
  • Residency Compliance Certification Form: Adobe PDF
• Resignation Form (CBP-123, R 10/07): MS Word / Adobe PDF
• Safety Glass Prescription Order Form (R 11/07): Adobe PDF
• Safety Orientation Checklist: Adobe PDF
• Selective Certification Authorization, Request for (CS-64, R 11/06): MS Word / Adobe PDF
• Self-Service Instructions & Information: click here
• Sick Leave Certification ( CBP-157): Adobe PDF
• Sick Leave or Injury Pay, Application for (CBP-156, R 1/95): MS Word / Adobe PDF
• Suspension Notice (CS-82, R 3/07): MS Word / Adobe PDF
• Temporary or Provisional Appointees Statement of Understanding (CS-114, R 3/07): MS Word / Adobe PDF
• Termination Notice (CS-80, R 3/07): MS Word / Adobe PDF
• Travel Advance, Authorization for (CBP-210, R 10/05): MS Word
• Tuition Benefit/Reimbursement Applications (ER-75): click here
• Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
• Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF
• Waiver Form (Health/Dental): Adobe PDF
• Worksite Assessment Form (R 11/05): Adobe PDF
• Written Warning (CS-79, R 3/07): MS Word / Adobe PDF
• W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF  
• W-4 Form (2008): Adobe PDF
• WT-4 Form (R 11/04) Employees Withholding Exemption Certificate /New Hire Reporting:  Adobe PDF