Find links to helpful forms.
Self-Screening Assessment Policy & Form
For Employees
- 2020 Conference/Training Travel Expense Reimbursement Claim Form (110-30)
- 2020 Daily Travel Expense Reimbursement Claim Form (110-58)
- 2019-2020 Statement of Economic Interests – Form 700
- 2020 CA EDD Employee’s Withholding Allowance Certificate (DE-4)
- 2021 IRS Employee’s Withholding Certificate (W-4)
- Catastrophic Sick Leave:
- Change of Address or Status Form
- Duplicate Wage and Tax Statement (IRS Form W-2) Authorization
- Educational Expense Reimbursement Claim Form
- Emergency Family Medical Leave Expansion Act (EFMLEA):
- Emergency Contact Form
- Employee Identification (ID) Card Request Form
- Employee of the Month – Nomination Form
- Employee Transfer Request (ETR) Form
- Employment Separation Notice (ESN)
- Ergo Evaluation Request (Online Process)
- Family and Medical Leaves – Certification of Health Care Provider
- Family and Medical Leaves – Employee Request for Leave
- Flextime Pilot Program Acknowledgment Form
- Incident Report Form
- Leave Request Form
- Military Leave Time Bank Program Donor Authorization
- Pre-Designation of Personal Physician
- Reasonable Accommodation:
- Countywide Job Search Referral
- Departmental Request for Reasonable Accommodation Assistance
- Reasonable Accommodation and Interactive Process Overview
- Reasonable Accommodation Declination/Waiver
- Release of Information Consent
- Request for Reasonable Accommodation (Applicant)
- Request for Reasonable Accommodation (Employee)
- Work Status Report
- Safety Suggestion Form
- STAR Award Nomination Form
- Timesheets:
- Visual Image Release Form
- Workers’ Compensation Claim Form DWC1
- Workers’ Compensation Witness to a Job Related Injury
- Workers’ Compensation Work Status Report