Download important forms and documents using the quick access links below
Benefits
Please click on each of the following tabs to locate the forms and documents associated with the Benefits topic.
Health & Welfare
Enrollment, Change, Cancellation, Or Opt Out—Employees Only, UPAY850 |
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Supplemental Life/Dependent Life Insurance Short-Form Health Questionnaire |
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For information about temporary layoffs, go to the roadmap - What to do if you're laid off temporarily |
Retirement & Savings
UCRP 1976 Tier Summary Plan for Members with Social Security |
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Disability
Reporting Your Disability Claim |
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UCR Parking Services - Payroll Deduction/Cancellation Request Form |
Sample Letters
Sample letters to employees who appointments have changed and will no longer have benefits:
Moving from Full Benefits or Mid-Level Benefits to No Benefits |
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Letters to employees whose appointments have changed and their benefits will be affected.
Education & Development
Education & Development Forms
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Employee & Labor Relations
Be sure to check back for the following letter templates. If you should have any questions or have an immediate need, please contact the Employee & Labor Relations Department.
Please click on each of the following tabs to locate the forms and documents associated with the Employee & Labor Relations topic.
Layoff Resources for Employees
UC Employee Outplacement Career Transition Services - Silver Package |
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Proposal for Reduction In Time or Layoff
Seniority Points
Notification of Indefinite Layoff
Academic Researchers (RA) | |
Patient Care Technical (EX) Unit |
Physicians, Dentists and Podiatrists (DX) |
Notifications of Indefinite Reduction in Time
Non-Represented Staff Employees |
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Non Senate Instructional Unit Continuing Lecturer (IX) |
Non Senate Instructional Unit Pre Six-year Lecturer (IX) |
Research Support Professional (RX) |
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Technical Unit Employees (TX) |
Notification of Indefinite Reduction in Time to Partial-Year Position
Clerical Unit Employees (CX) |
Non-Represented Staff Employees |
Research Support Professional (RX) |
Service Unit Employees (SX) |
Technical Unit Employees (TX) |
Notifications of Temporary Layoff
Research Support Professional (RX) |
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Notification of Temporary Reduction in Time
Severance Election
Notices Regarding Overtime Compensation
Research Support Professional Unit (RX) | |
Medical Separation
Notices of Intent to Medically SeparatePlease check back for updated Notices of Intent to Medically Separate |
Notices of Medical SeparationPlease check back for updated Notices of Medical Separation |
Academic Student Employees
UAW Local 2865 Membership Election & Dues Deduction Authorization Form |
Corrective Action
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Grievance Forms under PPSM 70 – Request for Formal Review
Grievance Form for Managers and Senior Professional Employees |
Grievance Form under Academic Personnel Manual (APM) 140 – Request for Formal Written Grievance Review
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Leave of Absence for Union Business
Reimbursement of Costs Associated with Leave of Absence for Union Business - Campus Guidelines |
Reimbursement of Costs Associated with Leave of Absence for Union Business - Billing Statement |
Postdoctoral Scholar
UAW Postdoctoral Scholar Deduction Authorization Form, effective August 2018 |
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Proof of Service
Proof of Service Proof of Service Form - Delivery by U.S. Mail |
Other
General Administration
Other
Form I-9: Employment Verification |
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