HR Forms and Checklists

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D-F Forms

  • DE4 - California Employees Withholding Certificate

    Free

    Copy and distribute this form from the EDD to employees to determine his/her withholding allowance.​​

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  • Deceased Employee Compensation Collection Form

    Provide this form to the surviving spouse, registered domestic partner, guardian or a conservator of an estate (Affiant) in order to allow collection of the Decedent's salary or other compensation.​

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  • Defining Harassment Quiz

    Use this quiz as a training tool during sexual harassment training for employees.​

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  • Direct Deposit Authorization

    Give this form to an employee who requests his pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.

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  • Direct Deposit Authorization - Spanish

    Give this form to an employee who requests his pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.

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  • Disclosure and Authorization to Obtain Investigative Consumer Report

    This form authorizes you to investigate and obtain an investigative consumer report about an employee or applicant in connection with a promotion or employment. The form is signed by the employee or applicant.

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  • Doctors First Report of Occupational Injury or Illness

    After an injured employee's first doctor's visit, the doctor completes this report and sends two copies to the employer's workers' compensation insurance carrier or the self-insured employer within five days of the initial examination. Failure to file a timely doctor's report may result in assessment of a civil penalty.​​

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  • Domestic Violence Checklist

    This form will help guide you through providing leave for an employee who has notified you that he or she has become a victim of domestic violence. ​​​

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  • Earned Income Tax Credit - Employer Required Notification

    Provide this form to employees along with their W-2 or 1099 to notify them of their rights under the federal and California Earned Income Tax Credit (EITC) program.

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  • Earned Income Tax Credit - Employer Required Notification - Spanish

    Provide this Spanish​ form to employees along with their W-2 or 1099 to notify them of their rights under the federal and California Earned Income Tax Credit (EITC) program.

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  • Education Leave Checklist

    Use this checklist to create and implement an education leave policy for your company.

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  • EEO Reporting Requirements

    Review this chart to help determine if you are required to collect and provide gender, racial and ethnic workforce data to the federal Equal Employment Opportunity Commission, also known as EEO Reporting.

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  • Emergency Action Plan

    Personalize

    Use this form to set up an Emergency Action Plan (EAP) for the workplace. The EAP inlcudes which employees are in charge in case of an emergency and emergency contact phone numbers.

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  • Emergency Information

    Personalize

    Use this form to obtain an employee's contact information in case of emergency. Keep this form in the employee's personnel file.

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  • Emergency Information - Spanish

    Use this form to obtain an employee's contact information in case of emergency. Keep this form in the employee's personnel file.

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  • Employee Disciplinary Warning

    Use this form to record a disciplinary warning issued to an employee and the employee's acknowledgment of the warning.

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  • Employee Letter - PDL Only

    Use this letter to respond to notice of an employee’s absence due to Pregnancy Disability Leave (PDL). Respond within 10 calendar days of the request or no later than the following payday, whichever is sooner. Use this letter if you are under 50 employees and not covered by the federal Family Medical Leave Act (FMLA) or if the employee seeking leave is not eligible for FMLA leave.​​​

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  • Employee Orientation Checklist

    Personalize

    Have an employee complete this form as you go through the orientation process, ensuring that you cover all necessary topics and distribute all required forms. ​

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  • Employee Safety Information

    ​​​Make this form available to all employees to use to report workplace safety concerns. The employee should be allowed to submit the form anonymously. Document written employee safety concerns along with any actions taken to investigate/respond. Use this form along with your Injury and Illness Prevention Program.​

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  • Employer Proof of Identity and Disbursement of Final Pay - Deceased Employee

    Complete this form upon receipt of the Deceased Employee Compensation Collection Form. Place a copy of this completed form in the Decedent's file and provide a copy to the Affiant.​​​​

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  • Employers Report of Occupational Injury or Illness

    Use this form to report an employee's injury or illness if it requires more than first aid. Send a copy to your insurer, or if self-insured, to the Department of Industrial Relations within five days following notice of injury or illness.

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  • Employing Minors Checklist

    Use this checklist to ensure compliance when employing minors.

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  • Employment Application - Long Form

    Personalize

    Use this form for new applicants. The long form includes space for more detailed information and employment history, and all other necessary sections. Only seek criminal history information when you can show that the information requested is specifically job related for the position the applicant is seeking and consistent with business necessity. State and local agencies are generally prohibited from asking applicants about criminal convictions, unless required by law. If you are recruiting for positions in Los Angeles and San Francisco, use the Employment Application for Los Angeles and San Francisco Employers — Long Form.​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​​​​​​​​​​

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  • Employment Application - Long Form - Instructions

    Updated

    Download and read these Instructions prior to using Employment Application - Long Form and Employment Application - Long Form - Spanish​.​​​

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  • Employment Application - Long Form - Spanish

    Personalize

    Use this form for new applicants. The long form includes space for more detailed information and employment history, and all other necessary sections. Only seek criminal history information when you can show that the information requested is specifically job related for the position the applicant is seeking and consistent with business necessity. State and local agencies are generally prohibited from asking applicants about criminal convictions, unless required by law. ​If you are recruiting for positions in Los Angeles and San Francisco, use the Employment Application for Los Angeles and San Francisco Employers – Long Form.​​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​

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  • Employment Application - Short Form

    Personalize

    Use this form for new applicants. The short form requires less employment history information. Only seek criminal history information when you can show that the information requested is specifically job related for the position the applicant is seeking and consistent with business necessity. State and local agencies are generally prohibited from asking appl​icants about criminal convictions, unless required by law. ​If you are recruiting for positions in Los Angeles and San Francisco, use the Employment Application for Los Angeles and ​San Francisco Employers – Short Form.​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​

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  • Employment Application - Short Form - Instructions

    Updated

    Download and read these instructions prior to using Employment Application - Short Form and Employment Application - Short Form - Spanish​.​​

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  • Employment Application - Short Form - Spanish

    Personalize

    Use this form for new applicants. The short form requires less employment history information. Only seek criminal history information when you can show that the information requested is specifically job related for the position the applicant is seeking and consistent with business necessity. State and local agencies are generally prohibited from asking applicants about criminal convictions, unless required by law. ​If you are recruiting for positions in Los Angeles and San Francisco, use the Employment Application for Los Angeles and San Francisco Employers – Short Form.​​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​​​​​​

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  • Employment Application for Los Angeles and San Francisco Employers - Long Form

    Personalize

    Employers covered by Los Angeles' Fair Chance Initiative and San Francisco’s Fair Chance Ordinance (FCO) should use this form for applicants. Employers covered by the ordinance cannot ask about criminal history on a job application. The long form includes space for more detailed information and employment history, and all other necessary sections. Download and read the Instructions prior to using this employment application form.

    Instructions​​​​​​​​​

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  • Employment Application for Los Angeles and San Francisco Employers - Long Form - Instructions

    Download and read these instructions prior to using Employment Application for Los Angeles and San Francsico Employers - Long Form and Employment Application for Los Angeles and San Francsico Employers - Long Form - Spanish.​

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  • Employment Application for Los Angeles and San Francisco Employers - Long Form - Spanish

    Personalize

    Employers covered by Los Angeles' Fair Chance Initiative and San Francisco’s Fair Chance Ordinance (FCO) should use this form for applicants. Employers covered by the ordinance cannot ask about criminal history on a job application. The long form includes space for more detailed information and employment history, and all other necessary sections. Download and read the Instructions prior to using this employment application form.​

    Instructions​​​

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  • Employment Application for Los Angeles and San Francisco Employers - Short Form

    Personalize

    Employers covered by Los Angeles' Fair Chance Initiative and San Francisco’s Fair Chance Ordinance (FCO) should use this form for applicants. Employers covered by the ordinance cannot ask about criminal history on a job application. The short form requires less employment history information.​​​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​​​​​​

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  • Employment Application for Los Angeles and San Francisco Employers - Short Form - Instructions

    ​Download and read these instructions prior to using Employment Application for Los Angeles and San Francisco Employers - Short Form and Employment Application for Los Angeles and San Francisco Employers - Short Form - Spanish.​​​

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  • Employment Application for Los Angeles and San Francisco Employers - Short Form - Spanish

    Personalize

    Employers covered by Los Angeles' Fair Chance Initiative and San Francisco’s Fair Chance Ordinance (FCO) should use this form for applicants. Employers covered by the ordinance cannot ask about criminal history on a job application. The short form requires less employment history information. Download and read the Instructions prior to using this employment application form.

    Instructions​​​​

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  • Employment Determination Guide - Form DE38

    Free

    Use this worksheet to determine whether a worker is most likely an employee or an independent contractor.​

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  • Employment Interview Checklist

    Use this sample checklist to ensure that your interview process is the same for all applicants and does not expose you to lawsuits.

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  • Employment Letter

    Personalize

    Use this letter to convey information to a new employee about whom they will report to, job title, starting date and time, rate of pay and classification. This letter is simply for an employee’s information and is not to be used or construed as a contract of employment. ​

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  • Equal Employment Opportunity Data

    Use this form to collect information from an employee for equal opportunity employment purposes. The form is entirely voluntary for the employee and information must remain confidential and not affect application for employment.

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  • Ergonomics Checklist - Computer and Keyboard Issues

    Use this checklist as an inspection tool to help you identify potential ergonomic problems related to computers and keyboards.

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  • Ergonomics Checklist - Hand Tool Use

    Use this checklist as an inspection tool to help you identify potential ergonomic problems related to hand tool use.

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  • Ergonomics Checklist - Manual Handling

    Use this checklist as an inspection tool to help you identify potential ergonomic problems related to manual handling.

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  • Ergonomics Checklist - Task-Work Methods

    Use this checklist as an inspection tool to help you identify potential ergonomic problems related to task/work methods.

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  • Ergonomics Checklist - Workstation Layout

    Use this checklist as an inspection tool to help you identify potential ergonomic problems related to workstation layout.

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  • Exempt Analysis Worksheet - Administrative Exemption

    Use this worksheet to help evaluate the exempt or nonexempt status for your administrative employees.​​

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  • Exempt Analysis Worksheet - Computer Professional Exemption

    Use this worksheet to help evaluate the exempt or nonexempt status for your computer professionals.​​

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  • Exempt Analysis Worksheet - Executive Managerial Exemption

    Use this worksheet to help evaluate the exempt or nonexempt status for your managers or executives.​

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  • Exempt Analysis Worksheet - Professional Exemption

    Use this worksheet to help evaluate the exempt or nonexempt status for your professional employees (such as teachers, doctors or attorneys).​

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  • Exempt Analysis Worksheet - Salesperson Exemption

    Use this worksheet to help evaluate the exempt or nonexempt status for your sales staff.

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  • Exit Interview

    Personalize

    Use this form to gather an employee's comments at termination regarding his or her employment with your company. Completion of the exit interview by an employee is entirely voluntary.

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  • Fair Credit Reporting Act - Summary of Your Rights

    Free

    Provide a copy of this summary to the consumer (employee or applicant) before taking adverse action based on the results of a credit report. A copy of the report must accompany the summary.​​

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  • Fair Credit Reporting Act - Summary of Your Rights - Spanish

    Free

    ​Provide a copy of this summary to the consumer (employee or applicant) before taking adverse action based on the results of a credit report. A copy of the report must accompany the summary.​​

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  • Family Care and Medical Leave (CFRA Leave) and Pregnancy Disability Leave Notice - 50 or More Employees

    Free

    This notice must be posted and must also be given to an employee who is seeking pregnancy disability leave or reasonable accommodation/transfer for pregnancy, childbirth or related medical condition and/or who is seeking family care or medical leave. This notice applies to California employers with 50 or more employees (subject to the CFRA or FMLA). You must post this notice in a place commonly used by employees, such as a break room. Employers are also encouraged to give this notice at time of hire to each new employee. This notice is also part of the California and Federal Employment Notices Poster available at the CalChamber Store.​​

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  • Family Care and Medical Leave (CFRA Leave) and Pregnancy Disability Leave Notice - 50 or More Employees - Spanish

    Free

    This notice must be posted and must also be given to an employee who is seeking pregnancy disability leave or reasonable accommodation/transfer for pregnancy, childbirth or related medical condition and/or who is seeking family care or medical leave. This notice applies to California employers with 50 or more employees (subject to the CFRA or FMLA). You must post this notice in a place commonly used by employees, such as a break room. Employers are also encouraged to give this notice at time of hire to each new employee. This notice is also part of the California and Federal Employment Notices Poster available at the CalChamber Store.​

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  • Features of Mass Layoff and Plant Closing Laws

    Updated

    Review this chart any time you are considering a layoff of a large number of employees or the temporary or permanent close or relocation of a facility or department. This chart identifies covered employers, notification requirements, penalites, trigger events, exceptions and notice content.​

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  • Federal Family and Medical Leave Act Poster

    This poster satisfies the required federal posting notice regarding the availability of family and medical leave. This poster was revised in April of 2016. However, according to the Department of Labor, the February 2013 version of the FMLA poster is still good and can be used to fulfill the posting requirement.

    Employers should give a copy of this FMLA notice at the time of hire if they do not publish an employee handbook. Best practice is to provide the notice at time of hire regardless of whether you also include the notice in your employee handbook.​​​​​

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  • Federal Family and Medical Leave Act Poster - Spanish

    This poster satisfies the required federal posting notice regarding the availability family and medical leave. This poster was revised in 2016. However, according to the Department of Labor, the February 2013 (Revised September 2013) version of the FMLA poster is still good and can be used to fulfill the posting requirement.

    Employers should give a copy of the FMLA notice at the time of hire if they do not publish an employee handbook. Best practice is to provide the notice at time of hire regardless of whether you also include the notice in your employee handbook.​​​

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  • Federal Minimum Wage Poster - Black and White

    Free

    Every employer of employees subject to the Fair Labor Standards Act's minimum wage provisions must post, and keep posted, a notice explaining the Act in a conspicuous place in all of their establishments so as to permit employees to readily read it. ​​

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  • Federal Minimum Wage Poster - Color

    Free

    Every employer of employees subject to the Fair Labor Standards Act's minimum wage provisions must post, and keep posted, a notice explaining the Act in a conspicuous place in all of their establishments so as to permit employees to readily read it.​

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  • Federal Minimum Wage Poster - Spanish - Black and White

    Free

    Every employer of employees subject to the Fair Labor Standards Act's minimum wage provisions must post, and keep posted, a notice explaining the Act in a conspicuous place in all of their establishments so as to permit employees to readily read it. Spanish version.​​

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  • Federal Minimum Wage Poster - Spanish - Color

    Free

    Every employer of employees subject to the Fair Labor Standards Act's minimum wage provisions must post, and keep posted, a notice explaining the Act in a conspicuous place in all of their establishments so as to permit employees to readily read it. Spanish version.​​​

    Preview  |  Download

  • Final Paycheck Acknowledgment

    Use this form to have an employee certify receipt of final paycheck.

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  • Final Paycheck Acknowledgment - Spanish

    Use this form to have an employee certify receipt of final paycheck. Employers not fluent in Spanish should refer to the English version to complete this form properly.

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  • Final Paycheck Direct Deposit Authorization

     Give this form to an employee who requests his final pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.

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  • Final Paycheck Direct Deposit Authorization - Spanish

    Give this form to an employee who requests his final pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.

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  • Final Paycheck Worksheet

    Personalize

    Use this form to calculate the amount of an employee’s final paycheck. It is illegal for an employer to withhold a final paycheck and failure to pay all wages due may result in penalties.

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  • Fire Prevention Checklist

    Use this checklist to collect information related to fire prevention and to make sure you are taking proper measures to prevent fires in the workplace. This includes auditing those measures to ensure that they are being followed. This information should be integrated into your Fire Prevention Plan.  ​

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  • Fire Prevention Plan

    Personalize

    Use this form to set up a Fire Prevention Plan (FPP) for the workplace. The FPP inlcudes which employees are in charge in case of a fire and emergency contact phone numbers for local fire departments. 

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  • FMLA - Family Member Leave for a Qualifying Exigency

    This chart describes the types of events that give an eligible employee a reason for leave because of a qualifying exigency under the FMLA arising because the spouse, son, or child of the employee is on covered active duty or call to active duty.​ 

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  • FMLA - Family Member Leave for a Qualifying Exigency - Spanish

    This chart describes the types of events that give an eligible employee a reason for leave because of a qualifying exigency under the FMLA arising because the spouse, son, or child of the employee is on covered active duty or call to active duty.​ ​

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  • FMLA - Notice of Eligibility and Rights and Responsibilities

    Personalize

    Use this form to notify employees taking a family medical leave only regarding their eligibility for leave and any associated righ​ts and responsibilities.​ ​​

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  • FMLA - Notice of Eligibility and Rights and Responsibilities - Spanish

    Personalize

    Use this form to notify employees taking a family medical only leave regarding their eligibility for leave and any associated rights and responsibilities. ​​

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  • FMLA CFRA Designation Notice

    Personalize

    (Approval/Conditional Approval/Denial)

    Use this form to designate leave as FMLA/CFRA, to provide conditional approval of the request for leave if more information is necessary, or to deny the request.​​

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  • FMLA CFRA Designation Notice - Spanish

    Personalize

    Approval/Conditional Approval/Denial

    Use this form to designate leave as FMLA/CFRA, to provide conditional approval of the request for leave if more information is necessary, or to deny the request.​​​

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  • FMLA CFRA Documentation Checklist for Employer Use Only

    Use this checklist to assist you in complying with all regulations regarding family medical leave and CFRA leave. ​​​

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  • FMLA CFRA Policy Checklist

    This checklist will guide you through creating a Family and Medical Leave Policy. ​​​

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  • FMLA PDL Designation Notice

    Personalize

    Use this form to notify an employee if her leave for PDL/FMLA is approved, conditionally approved, or denied. ​​

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  • FMLA PDL Designation Notice - Spanish

    Personalize

    Use this form to notify an employee if her leave for PDL/FMLA is approved, conditionally approved, or denied.  ​​​

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  • FMLA Sample Policy - 50 or More Employees

    Use this policy to satisfy the requirements regarding family medical leave.​

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  • FMLA Sample Policy - 50 or More Employees - Spanish

    Use this policy to satisfy the requirements regarding family medical leave.​​​​​

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