INFORMATION & FORMS
Alphabetical Listing by Title
Listing by PER Form #
FORM#
FORM NAME
PER59
BILINGUAL PROGRAM FORM
PER65AF
POSITION DESCRIPTION FORM - SHORT FORM
PER65BF
POSITION DESCRIPTION FORM - LONG FORM
PER66
POSITION DESCRIPTION FORM SUPPLEMENT FOR SUPERVISORY POSITIONS
PER169
JUSTIFICATION TO HIRE A RETIRED ANNUITANT
PER191
EEO REGULATIONS
PER1020A
INPROCESSING - REGULAR EMPLOYEE LETTER
PER1020B
INPROCESSING - EH EMPLOYEE LETTER
PER1021A
INPROCESSING - REG EMPLOYEE DOCUMENTS
PER1021B
INPROCESSING - EH EMPLOYEE DOCUMENTS
PER1022
EMPLOYMENT ELIGIBILITY - I95 DOCUMENTATION
PER1025
HEALTH QUESTIONNAIRE
PER1025B
PRE-EMPLOYMENT HEALTH QUESTIONNAIRE
PER1026
DEFERRED COMP WELCOME LETTER
PER1030B
INSURANCE SUMMARY- DEPUTY PROBATION OFFICER ASSN UNIT
PER1030D
INSURANCE SUMMARY - CORRECTIONAL OFFICER
PER1030G
INSURANCE SUMMARY - GENERAL REP
PER1030L
INSURANCE SUMMARY - LAW ENFORCEMENT & SHERIFF'S SUPERVISORY
PER1030M
INSURANCE SUMMARY - MIDDLE/EXECUTIVE MANAGEMENT, ATTORNEYS
PER1030P
INSURANCE SUMMARY - PHYSICIANS
PER1030S
INSURANCE SUMMARY - LAW ENFORCEMENT MIDDLE MANAGEMENT
PER1030T
INSURANCE SUMMARY DA INSPECTORS
PER1031
BENEFITS - SELF FUNDED DENTAL PLAN
PER1032
DELTA CARE DENTAL
PER1033
ADDITIONAL LIFE RATES
PER1037
PROBATION DEPARTMENT GRIEVANCE FORM
PER1040
NEW EMPLOYEE STATUS & INFO SUMMARY
PER1041A
SALARY/COMP/LEAVE - GENERAL REP UNIT
PER1041B
SALARY COMP LEAVE - LE & SGTS UNITS
PER1041C
SALARY/COMP/LEAVE - MID MGT UNIT
PER1041D
SALARY/COMP/LEAVE - LEMM UNIT
PER1041E
SALARY/COMP/LEAVE - MGT TRAINEES
PER1041F
SALARY/COMP/LEAVE - OTHER EXEC MGT/DA ATTORNEY
PER1041G
SALARY/COMP/LEAVE - APPTED DEPT HEAD/ASST
PER1041H
SALARY/COMP/LEAVE - BOARD & ELECTED DH
PER1041I
SALARY/COMP/LEAVE - CORRECTION OFF
PER1041J
SALARY/COMP/LEAVE - DA INSPECTOR UNIT
PER1041K
SALARY/COMP/LEAVE - PHYSICIANS’ REPRESENTATION UNIT
PER1041L
SALARY/COMP/LEAVE-DEPUTY PROBATION OFFICER UNIT
PER1042A
CalPERS RETIREMENT CHECK LIST-MISCELLANEOUS
PER1042B
CalPERS RETIREMENT CHECK LIST-SAFETY-COUNTY PEACE OFFICER
PER1042C
CalPERS RETIREMENT CHECK LIST-SAFETY-SHERIFF
PER1053
BOARD OF SUPERVISOR'S POLICY: FLSA
PER1054
EXTRA HELP EMPLOYMENT REQUIREMENTS
PER1056
FMLA NOTICE - GENERAL UNIT
PER1057
FMLA NOTICE - LAW ENFORCEMENT UNIT
PER1058
FMLA NOTICE - MIDDLE MGT UNIT
PER1059
FMLA NOTICE - LAW ENF MID MGT UNIT
PER1060
FMLA NOTICE - CORRECTIONAL OFFICER UNIT
PER1061
FMLA NOTICE - DA'S & EXEC MGT
PER1063
NOTIFICATION OF POLICIES
PER1073
REQUEST FOR MILITARY LEAVE-ACTIVE DUTY
PER1081A
PHYSICIAN'S CERT - LEAVE OF ABSENCE-EMPLOYEE
PER1081B
PHYSICIAN'S CERT - FMLA
PER1082A
EMPLOYEE REQUEST FOR TIME OFF
PER1083
EMPLOYEE REQUEST LOA W/OUT PAY
PER1084
EMPLOYEE OBLIGATIONS UNDER FMLA
PER1085
RESPONSE TO EMPLOYEE REQUEST FOR FMLA LEAVE
PER1086
PHYSICIAN'S CERTIFICATION - RETURN FROM LEAVE
PER1088
VOLUNTARY REDUCTION OF HOURS FORM
PER1089
VOLUNTARY TIME OFF FORM
PER1095
DONATION OF ACCRUED PAID LEAVE - TIME BANK
PER1100A
REASONABLE ACCOMMODATION REQUEST
PER1142
MEDICAL AUTHORIZATION RELEASE FORM
PER1171
EMPLOYEE PERFORMANCE EVAL AND DEV REP
PER1200
PAYROLL TRANSACTION CODES
PER1201
PAYROLL EMPLOYEE STATUS CODES
PER1202
BENEFIT STATUS CODES/DEFINITIONS
PER1203
PAYROLL/PERSONNEL POSITION NUMBER CODES
PER1205
PAYROLL NAME CHANGE
PER1206
RETRAINING PAY ADJUSTMENT FORM
PER1207
DIFFERENTIAL FORM
PER1208
PAYROLL CODES - UNFUNDED & PARTIAL YR
PER1209
CHANGE OF ADDRESS/TELEPHONE FORM
PER1301
GRIEVANCE FORM - GENERAL REP UNIT
PER1302
GRIEVANCE FORM - LAW ENFORCEMENT UNIT
PER1303
GRIEVANCE FORM - MIDDLE MGT UNIT
PER1304
GRIEVANCE FORM - LAW ENF MID MGT UNIT
PER1305
GRIEVANCE FORM - CORRECTIONAL OFFICER UNIT
PER1306
GRIEVANCE FORM - DA ATTORNEYS UNIT
PER1307
GRIEVANCE FORM - PHYSICIAN'S REPRESENTATION UNIT
PER1360
TUITION REIMBURSEMENT FORM - GENERAL REP
PER1420
DOMESTIC PARTNER AFFIDAVIT
PER1422
STATEMENT OF DOMESTIC PARTNER TERMINATION
PER1507B
DOT REQUIREMENTS - EMPLOYEE NOTICE
PER1801
SALARY STUDY REQUEST
PER3011
REFERENCE CHECK - RELEASE/WAIVER FORM
PER3039
NEW POSITION REQUEST/BOS ACTION
PER3061
GUIDE TO DEPARTMENTAL SELECTION INTERVIEW
PER3116
REQUEST FOR CLASSIFICATION STUDY
PER3124
CIVIL SERVICE COMMISSION APPEAL INFORMATION
PER3125
CIVIL SERVICE COMMISSION APPEAL FORM
PER3133
STUDENT WORKER SITE AGREEMENT
PER3151
REMOVE CANDIDATE FROM LIST REQUEST
PER3161
REQUEST PLACE ON EMPLOYMENT TRAINING LIST
PER4002
DISCRIMINATION/HARASSMENT COMPLAINT
PER4003
ADA FORMAL COMPLAINT INSTRUCTIONS
PER4027
EEO/NONDISCRIMINATION & REASONABLE ACCOMODATION POLICY BROCHURE
PER5003
CLAIM AGAINST THE COUNTY OF SANTA CRUZ
PER5003S
CLAIM AGAINST THE COUNTY OF SANTA CRUZ(Spanish)
PER5004
VEHICLE ACCIDENT REPORT
PER5006
EMPLOYEE CLAIM - EQUIPMENT LOSS/STOLEN
PER5012
INCIDENT REPORT FORM - NON EMPLOYEE
PER5013
PROPERTY LOSS REPORT FORM
PER5013DPW
PROPERTY LOSS REPORT FORM FOR DEPART OF PUBLIC WORKS
PER5300A
SEPARATION PACKET
PER5300B
SEPARATION PACKET - EDD
PER6051
SAFETY SUGGESTION FORM
PER6056
LONGEVITY DIFFERENTIAL AFFIDAVIT
PER6057
LONGEVITY DIFFERENTIAL AFFIDAVIT - EXTRA HELP
PER7000
DA INSPECTOR CELLULAR PHONE REIMBURSEMENT FORM
PER7001
DA/CHILD SUPPORT ATTORNEYS CELLULAR PHONE REIMBURSEMENT FORM
VIP
VIP - ACCIDENT POLICY
VIP
VIP - ACCIDENT FORM
VIP
VIP - APPLICATION PACKET
VIP
VIP - AUTO INSURANCE
VIP
VIP - DEPARTMENT REQUEST
VIP
VIP - TIMESHEET
VIP
VIP - TIPS FOR COMPLETING A DEPARTMENT REQUEST FORM