the New Hire Paperwork Checklist First!

NEW HIRE PAPERWORK CHECKLIST
Name of Employee: __________________________________
RECEIVED
DESCRIPTION OF FORM OR DOCUMENT
I-9—Verify required forms of identification
W-4
Oath of Office
Policy Acknowledgement Form Employee Conduct/Behavior Expectations
Workweek Designation
At-Will Status Acknowledgement
Deputy Oath
Appointment above 1st step or bottom of band
Personnel Action Form—PAF
LIVESCAN Service—fingerprint form for Sheriff’s Department (Visual Sample)
Union Deduction Form
EXPLANATION
Effective 3-8-13—Expires 3-31-16
For the current year
Form 2015-82
Revised 5-31-12
Fair Labor Standards Act-FLSA Revised12-04
Management/Confidential only
Sworn job classifications—County Clerk Form 13
Memo when applicable
Report is generated from PeopleSoft.
SCOE has all of the form templates.
Revised 6-2013
RISK MANAGEMENT
RECEIVED
DESCRIPTION OF FORM OR DOCUMENT
Medical Provider Network Brochure—Spanish version available upon request
from RMD
Acknowledgement Form confirming receipt of WC and MPN brochures
DWC—Time of Hire Pamphlet
Post Offer/Pre-Placement Screening Passport—Kaiser
(Word Document)
POST-Offer Medical Testing Program Department Instructions/Overview
Family Medical Leave of Absence Policy (FMLA)
Certification of Health Care Provider for FMLA—Employee & Family Member
Certification
Your Rights and Responsibilities under Family Medical Leave of Absence
(FMLA)
What Does Healthcare Reform Mean to You? Fact Sheet
EXPLANATION
Revised 7-1-09—Thirteen page brochure from
RMD
Memo revised 7-1-09
Revised 3-1-07
Click on the drop down menu first to select
your customized departmental form. Rev. 7-12
Revised June 2012
Revised January 2009
Revised June 2009
Revised January 2009
Provide to Part-Time Employees – Revised 1/2015
EXTRA-HELP RETIRED COUNTY EMPLOYEE (Rehiring a Retiree as a Part Time Employee or PSC)
RECEIVED
RETIREMENT
RECEIVED
DESCRIPTION OF FORM OR DOCUMENT
Rehiring a Retired County Employee Checklist
EXPLANATION
Revised 2-27-13
All Retirement Forms Can Now Be Completed Online Before Printing!
DESCRIPTION OF FORM OR DOCUMENT
Retirement Member Enrollment Form
Notice to Prospective Members Form 415
Beneficiary Designation Form Instructions for Active Members
Beneficiary Designation Form
EXPLANATION
Revised 1-30-13 Attach copy of Birth Certificate
Revised 1-13
New Added 7-08
Revised 5-09
DEPARTMENT TO COMPLETE
Received Copy of Application Form
Yes □
Requisition Number:
Exam Plan:
PLEASE SUBMIT ALL FORMS TOGETHER TO THE CHIEF EXECUTIVE OFFICE/HUMAN RESOURCES UNIT
Effective 6-29-13 All Benefit Forms Should Be Sent Directly Via Groupwise E-Mail to: CountyBenefits@stancounty.com
Prepared by:
Department:
Date of Completion:
Name of Payroll Clerk:
Revised 01-08-15