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Forms

 

  • Beneficiary Designation (PDF)
  • Beneficiary Designation for TIAA (PDF)
  • Blue Cross PPO Claim Form (PDF)
  • Childcare Assistance Program (CCAP) Application (PDF)
  • Delta Dental Claim Form (PDF)
  • Dependent Care Reimbursement (HTML)
  • Direct Deposit (PDF)
  • Direct Deposit Cancellation (PDF)
  • Employee Data Administration Access Request (PDF)
  • Employee's Withholding Allowance Certificate - EDD Form DE-4 (PDF)
  • Exit Interview (Excel or PDF)
  • Extended Workweek Request (Word or PDF)
  • External Affiliate Guide & Forms (HTML)
  • Formal Problem Resolution Request (PDF)
  • Flexible Spending Account Reimbursement (HTML)
  • Guest Guidelines & Forms (HTML)
  • Guidelines for Operation of Unmanned Aircraft Systems (Drones) and Other Airborne Objects (PDF)
  • Health and Dental Insurance Designation Request (PDF)
  • Human Resources System Responsibilities Access Request (PDF)
  • Leave of Absence Request - Form P21 (PDF)
  • Personal Leave of Absence Request - Form P21-A (PDF)
  • Make Up Time Request (PDF)
  • Member of the Professional Staff Recommendation Form (PDF)
  • Nepotism Evaluation Form (PDF)
  • Notary Public Approval & Authorization Form (PDF)
  • Outside Activity Request (PDF)
  • Performance Review Form (Word)
  • Performance Review Form for Graded Staff (Word)
  • Personnel File Review Request Form (PDF)
  • Personnel Information Change Notice - Form P53 (Word or PDF)
  • Predesignated Physicians Forms (HTML)
  • Staff Personnel Requisition - Please use the web-based recruiting system. For information on filling a position or for information on applying for a transfer, please contact Employment at (626) 395-8661.
  • Staff Prize Nomination Form (PDF)
  • Student Employee Data Sheet (Excel)
  • Take Our Children to Work Day (PDF)
  • Termination Clearance Sheet (PDF) - For instructions, please refer to the Termination Process Sheet.
  • Time and Leave Report - Exempt (PDF)
  • Time and Leave Report - Non-Exempt (PDF)
  • Tuition Reimbursement Plan - Application - Form 15-15A (PDF)
  • Tuition Reimbursement Plan - Funds Request - Form 15-15B (Word or PDF)
  • Vehicle Use For Non-Caltech Personnel: Consent, Release (PDF)
  • Volunteer Forms and Guidelines (HTML)
  • W-2 Form - Online W-2 Opt-In Form (PDF)
  • W-4 Form - Employee's Withholding Allowance Certificate (PDF)