Forms

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Forms

Title Short Description Topic Campus
Access Violation Report

Department fills out form when employee organizations commit unauthorized or illegal actions.
Submit to: ELR Department

Employee and Labor Relations UC Davis Download
Catastrophic Leave - Employee Request for Catastrophic Leave

Form through which employees who have exhausted their personal leave options can request leave donations from colleagues or the University pool for Catastrophic Leave.
Submit to: Supervisor/Manager or Department Human Resources

Employee and Labor Relations UC Davis and UC Davis Health Download
Compensatory Time Notification Form (CX Unit) (Davis Campus Only)

Allows employees in the Clerical and Allied Services Unit (CX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (EX Unit) (Davis Campus Only)

Allows employees in the Patient Care Technical Unit (EX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (F3 Unit) (Davis Campus Only)

Allows employees in the Fire Fighter Unit (F3) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (HX Units) (Davis Campus Only)

Allows employees in the Health Care Professionals Unit (HX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (K3 Unit) (Davis Campus Only)

Allows employees in the Skilled Trades Unit (K3) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (Non-Represented Staff) (Davis Campus Only)

Non-exempt employees on the Davis campus are entitled to either Over Time or Compensatory Time Off (CTO). Comp. Time is allowed at the manager’s discretion. This form allows the employee to opt for CTO in lieu of OT if approved.
Submit to: Create AggieService ticket, upload form to ticket, shared services will make the adjustment.

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee. 

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (RX Unit) (Davis Campus Only)

Allows employees in the Research Support Professionals Unit (RX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee. 

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (SX Unit) (Davis Campus Only)

Allows employees in the Service Unit (SX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee. 

Employee and Labor Relations UC Davis Download
Compensatory Time Notification Form (TX Unit) (Davis Campus Only)

Allows employees in the Technical Unit (TX) to elect how they receive compensation for overtime.
Submit to: Original to Supervisor, copy to Employee

For all UC Davis Health employees, supervisors and managers are responsible for identifying eligible employees under UCDH Policy 2920 (CTO Accrual for Eligible Employees) and obtaining approval for CTO enrollment from Employee and Labor Relations.  Once eligibility has been confirmed, Payroll will create a CTO bank for the employee.

Employee and Labor Relations UC Davis Download
Meal Period Waiver/Missed Meal and Rest Break

The Meal Period Waiver form is used to waive meal periods for employees that are required to have meal and rest periods in accordance with California Labor Code section 512.1.

The Missed Meal and Rest Break form is used to document if an employee is unable to take their meal or rest break due to an operational requirement or constraint.

Employee and Labor Relations UC Davis
Notice of Intent to Change Conditions of Employment

Departments use this form to notify HR of changing employment conditions, HR then notifies the Union.
Submit to: ELR Department

Employee and Labor Relations UC Davis and UC Davis Health Download
Position Closure Proposal

Complete form to initiate an indefinite position closure proposal.
Submit to: ELR Department

Employee and Labor Relations UC Davis Health Download
Position Closure Special Skills Addendum

Because position closure occurs in reverse seniority order, less senior employees inform departments of special skills that may prevent layoff.
Submit to: Compensation/Classification

Employee and Labor Relations UC Davis Health Download
PPSM 70 Employee Complaint Form

Allows PSS and MSP employees to file an official complaint.
Submit to: ELR Department

Employee and Labor Relations UC Davis and UC Davis Health Download
Pre-Action Review Protocol

This protocol is for use in pre-disciplinary action reviews.

Employee and Labor Relations UC Davis and UC Davis Health Download
Probationary Period - Change End Date (Davis Campus)

Managers and Supervisors can complete this form to request to change and employee's probationary period end date.
Submit to: Department assigned Employee Relations Consultant

Employee and Labor Relations UC Davis Download
Probationary Period - Change End Date (Health Campus)

Managers and Supervisors can complete this form to request to change an employee’s probationary period end date.
Submit to: HR Administration

Employee and Labor Relations UC Davis Health Download
Separation Checklist for Supervisors

A checklist of responsibilities when a supervisor separates.
Submit to: For supervisor use only.

Employee and Labor Relations UC Davis Health Download
STAR Plan Nomination Form

Managers and Supervisors can complete this form to nominate someone for the Star Recognition program.
Submit to: Executive Director, then to Vice Chancellor

All, Employee and Labor Relations UC Davis Link
Union Job Steward Grievance-Related Release Time Request

Union designated employee representative fills out form to request paid release time for grievance-related activities.
Submit to: Employee's Supervisor

Employee and Labor Relations UC Davis and UC Davis Health Download