Acknowledgement of Mandated Reporter Status and Legal Duty to Report Child Abuse and Neglect (EO 1083)
Equal Opportunity and Compliance
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California law requires certain people, known as “Mandated Reporters,” to report known or suspected child abuse or neglect. You have been identified as a certain type of Mandated Reporter: a Limited Reporter under Penal Code § 11165.7(a)(41). As a Mandated Reporter, you are required by the law to sign this statement acknowledging your legal reporting obligations.
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Child Abuse Reporting Form
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To Be Completed by Mandated Child Abuse Reporters Pursuant to Penal Code Section 11166
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This form is used to report certain payments received by state and local government agencies. It includes: • a payment for an official’s travel expenses for the purpose of facilitating the public’s business in lieu of a payment using agency funds; and • a payment that would otherwise be considered a gift or income to the benefiting official, but is instead accepted on behalf of the agency.
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Employee/applicant shall contact the treating health care provider to complete this form. Employee/ applicant should return the completed form to ADA coordinator at Cal Poly Humboldt Human Resources.
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This complaint form is to be used to file a Protected Disclosure of Improper Governmental Activities and/or Significant Threats to Health or Safety under Executive Order 929.
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The California Whistleblower Protection Act authorizes the California State Auditor to receive complaints from state employees and members of the public who wish to report an improper governmental activity. Note: Complaints are not accepted via email.
Onboarding
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Apply for an original Social Security card, apply for a replacement Social Security card, change or correct information on your Social Security number record
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The Reciprocal Self-Certification form allows you to provide essential information to your employer and will be used by your employer to enroll you into CalPERS membership.
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The Account Request process is used to add, modify, or delete a person's (user or developer) access to PeopleSoft Human Resources, PeopleSoft Campus Solutions, Customer Relationship Management, PeopleSoft Finance, and/or OBI enterprise applications.
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Important: This is NOT a designation for payment of death benefits and refund of employee retirement contributions.
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To enroll in Direct Deposit, complete this form.
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Use this form ONLY to change payroll designee. Employee starts the Adobe Sign Workflow.
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NOTE: USE THIS FORM FOR UPDATES ONLY- This form is required from the State and is used prior to employment or to make changes during employment, for determining exemption status for taxable deductions, and any other deductions sought. This form is also used for address & withholding changes.
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We recommend that you use Firefox or Chrome for this form. Internet Explorer may experience slow page loads.
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This is used for employees' information only. It does not replace the EAR or SPAR forms.
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We recognize that there are situations when a department will need to assist a new employee (e.g. Student Assistant or Special Consultant) with their sign-up documents. When a department commits to this responsibility, the designated person or persons commits to the proper handling of sensitive data.
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List of some of the important policies that you should be familiar with. Signature needed indicating that you received this document.
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Please use when funding changes are needed for current employees.
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NOTE: DO NOT USE THIS FORM FOR NEW STUDENTS. Use this form for Student Assistants and Work Study Payroll updates such as address change, name change, birthdate change, withholding allowance change and ethnic correction.
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Please send the complete form as an attachment to an email to payroll@humboldt.edu specifying your approval. No signature necessary for 2020.
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NOTE: DO NOT send the link to the volunteer. Follow the procedure in the Form's notes.
Onboarding, Payroll
Offboarding, Onboarding
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Application for Leave of Absence for Staff and Management Employees - Please print on pink paper
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Application for Leave of Absence for Staff and Management Employees - Please print on pink paper
Offboarding
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Do not use this form for Faculty
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Separation form for Part-time and Full-time Lecturers, FERP participants, Teaching Associates and Graduate Assistants. Completed each semester in accordance with the deadlines set by Academic Personnel Services. This document allows Payroll to inactivate temporary academic employees whose appointments have ended.
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Completed each semester in accordance with the deadlines set by Academic Personnel Services, or upon separation/end date of appointment. This document allows Payroll to inactivate temporary faculty unit employees whose appointments have ended.
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Completed each semester in accordance with the deadlines set by Academic Personnel Services or as needed throughout the term. This document allows Payroll to inactivate temporary academic student employees whose appointments have ended.
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Checklist to assist managers in identifying digital resources that require attention when an employee separates from their unit or the University, including leaves of absence.
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Must be completed before final pay check is issued. This Form IS NOT for continuing FERP or Reappointed Faculty/Staff.
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This form must be completed before final pay check is issued.
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NOTE: DO NOT SEND LINK TO EMPLOYEES - Instead fill out the form with the staff member and appropriate administrator emails and names and hit the Send button.
Recruitment
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***This form is only required if you don't use the "Request to Applicant for References" status in CHRS Recruiting - PageUp.*** Committees are encouraged to utilize the "Request to Applicant for References" status in CHRS Recruiting-PageUp as it will automatically prompt the candidate for additional information and alert the them that the committee intends to begin reference checks shortly. If needed, please obtain signed release of information form from candidate during their on-campus interview.
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The reference check forms will be submitted after moving the selected candidate(s) to the "Reference Check Successful/Recommendation to Dean for Hire" status in CHRS Recruiting (PageUp). Please be sure to document the the candidate's strengths and weaknesses in PageUp's "Search Committee Panel Review" section before you move your candidate(s) to the "Reference Check Successful/Recommendation to Dean for Hire". Please reach out to APS via email with any questions, aps@humboldt.edu.
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Vacancy Announcement Template for Probationary Faculty Unit Employee Positions
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Signed by all committee members and support staff for a Faculty Unit search to acknowledge and agree with specified confidentiality provisions.
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Signed by all committee members and support staff for an Academic Dean/Associate Dean search to acknowledge and agree with specified confidentiality provisions
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Use only when an Humboldt application is not required.
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During each academic year, a schedule is established for the submission of Probationary Faculty Unit Employee recruitment requests. Department must fill out Form 200: Position Request (Probationary Faculty Unit Employee) with required attachments for each position desired and submit it for review and approval.
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Use for tenure-track faculty wishing to distribute workload over three terms
Academic Employees, Recruitment
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Article 12 of the faculty Collective Bargaining Agreement requires that work be offered to qualified incumbent lecturers before it can be offered to any new or former lecturers.