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Spanish Forms

  • Absence Request - Spanish

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    Employees may use this form when requesting future time off or reporting previous time off. Remember employees can take mandatory paid sick leave upon verbal or written request. This form also gives your employees the opportunity to indicate a Family Medical Leave absence, although it is not required.​​​​

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  • Application for Permission to Work - Entertainment Industry - DLSE277 - Spanish

    Free

    Use this Division of Labor Standards Enforcement (DLSE) application when employing minors to work in the entertainment industry. This form is not a permit.

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  • Application to Employ Minors - Entertainment Industry - DLSE281 - Spanish

    Free

    Use this form if you are planning to hire a minor to work in the entertainment industry. This form is required by law.

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  • California Family Rights Act Brochure - Spanish

    This brochure outlines an employee’s right for leave under the California Family Rights Act (CFRA).​ You may choose to give this brochure to each employee eligible for CFRA and/or who requests leave that qualifies as CFRA, but there is no requirement that you do so.​

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  • Certification of Health Care Provider - Employees or Family Members Serious Health Condition - Spanish

    Updated  |  Personalize

    Have the employee's health care provider complete this medical certification as needed. This form is used for employee's taking leave under the Family Medical Leave Act (FMLA) and California Family Rights Act (CFRA) for their own serious health condition or that of a family member.​​​

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  • CHIP - Children's Health Insurance Program - Model Notice for Employers - Spanish

    Free  |  Updated

    If you are eligible for health coverage from your employer, but are unable to afford the premiums, some states have premium assistance programs that can help pay for coverage. These states use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.  ​​​​

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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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  • 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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  • 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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  • Employment Application - Long Form - Spanish

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    Use this form for new applicants. The long form includes space for more detailed information and employment history, and all other necessary sections. Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer.​ California also prohibits employers from asking job applicants about their prior salary history. Download and read the Instructions prior to using this employment application form.

    Instructions​​​​​​​​​​​​​​

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  • Employment Application - Short Form - Spanish

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    Use this form for new applicants. The short form requires less employment history information.​ Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer. California also prohibits employers from asking job applicants about their prior salary history.​​ Download and read the Instructions prior to using this employment application form.

    Instructions​​​​

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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 - 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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  • Federal Family and Medical Leave Act Poster - Spanish

    This poster satisfies the required federal posting notice regarding the availability family and medical leave.

    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 - 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.​​​

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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 - 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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  • 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 - Spanish

    Updated  |  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 - Spanish

    Updated  |  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 PDL Designation Notice - Spanish

    Updated  |  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 - Spanish

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

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  • H-2A Program Employee Rights - Spanish

    Free

    Required H-2A poster for employers with agricultural (H-2A) workers.  

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  • Harassment Complaint Form - Spanish

    Use this form to enable employees to report incidents of harassment.

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  • Harassment Complaint Procedure - Spanish

    Use this form to explain your company's harassment complaint procedure. Distribute the procedure along with your nonharassment policy to new employees, unpaid interns and volunteers. Consider annual redistribution of the form. Best practices would include distribution to independent contractors.​​

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  • Harassment Discrimination and Retaliation Prevention Policy - Spanish - Five or More Employees

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    Provide this policy to employee which states that you prohibit harassment, discrimination and retaliation in the workplace. A written prevention policy is mandatory for California employers. You must also ensure distribution of the policy to all employees.​​​Download and read the Instructions prior to using this policy.


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  • Harassment Discrimination and Retaliation Prevention Policy - Spanish - Less Than Five Employees

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    Provide this policy to employee which states that you prohibit harassment, discrimination and retaliation in the workplace. A written prevention policy is mandatory for California employers. You must also ensure distribution of the policy to all employees.​​​​​ Download and read the Instructions prior to using this policy.

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  • Heat Illness Prevention Plan - Outdoor Employees - Spanish

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    Use this sample form to develop your company's plan and procedures for complying with Cal/OSHA regulations on heat illness prevention for outdoor workers. This form describes minimal steps applicable to most outdoor work settings to help prevent heat illness.  Make sure to modify this sample form with specific procedures tailored to your workplace and the specific conditions at your worksites.  Additional helpful information is available from Cal/OSHA.​​​​​

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  • HIPP Notice - Spanish

    Updated

    Send this Spanish version at the same time you send the COBRA Notice, to notify Spanish-speaking terminating employees of special state programs that provide for the state to pay the COBRA premium under certain circumstances. Be careful not to confuse HIPP, California's Health Insurance Premium Payment Program, with HIPAA.​​

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  • I-9 - Employment Eligibility Verification - Instructions - Spanish

    Free

    ​Both employers and employees are responsible for completing their respective sections of Form I-9 to verify legal employment eligibility. ​Use these USCIS instructions to assist you in properly completing the Form I-9.​​

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  • I-9 - Employment Eligibility Verification - Spanish

    Free

    The Spanish version of Form I-9 may be filled out by employers and employees in Puerto Rico ONLY. Spanish-speaking employers and employees in the 50 states and other U.S. territories may print this for their reference but may only complete the form in English to meet employment eligibility verification requirements.

    The USCIS will only accept the 07/17/17 N​ edition of this form. ​You can find the edition date at the bottom of the page on the form. See the I-9 - Employment Eligibility Verification - Instructions​ or I-9 - Employment Eligibility Verification - Instructions - Spanish​ ​to assist you in properly completing the Form I-9​.​

    Instructions​​​​​​​​​​​​​​​

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  • Makeup Time Request - Spanish

    If you have a makeup time policy, have your employees use this form to request time off and schedule makeup time.

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  • Meal Break Waiver - Employee Shift 6 Hours or Less - Spanish

    When you have a nonexempt worker who will work a shift of six hours or less and both you and the worker wish to waive the required 30-minute meal break, use this form.

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  • Meal Break Waiver - Second Meal - Spanish

    When you have a nonexempt worker whose shift will be more than 10 hours but less than 12 hours, the worker has not waived his first meal break, and both you and the worker wish to waive the second required 30-minute meal break, use this form.

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  • Minimum Wage Order - Spanish

    Free

    Post this official California Minimum Wage notice next to the IWC Wage order for your industry.

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  • New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Do Not Offer a Health Plan) - Spanish

    Free

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who do not offer a health plan. ​​

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  • New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Offer a Health Plan) - Spanish

    Free

    Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who offer a health plan to some or all employees.  ​

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  • New Parent Leave Act (NPLA) Notice - Spanish

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    ​Give this notice to an employee who is seeking time off to bond with a new child or a child placed for adoption or foster care under California’s New Parent Leave Act (applies to employers with 20 or more employees). The New Parent Leave Act requires that employers provide employees with a guarantee of reinstatement before an employee begins his/her Parental Leave. This form will provide employees with notice of their reinstatement rights and other important information.

    If the employee is covered by FMLA/CFRA, use the FMLA/CFRA Designation Notice - Spanish and FMLA - Notice of Eligibility and Rights and Responsibilities - Spanish ​instead.

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  • Notice of Final Decision to Withdraw Employment Offer - Criminal History Only - Spanish

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    This form can be used to conduct a criminal background check after (1) a conditional offer of employment has been made to a job applicant and (2) the Notice of Preliminary Decision to Withdraw Employment Offer and the procedures described in it have been provided. Criminal background inquiries cannot be conducted prior to a conditional job offer and a final decision to withdraw an offer of employment based in any part on criminal history cannot be made until the Preliminary Notice and procedures have been provided.

    Use this form to notify an applicant that you have made the final decision to withdraw his/her conditional job offer based, at least in part, on a criminal background check.

    For information on obtaining and using criminal history, see Restrictions on Obtaining Criminal History and Obtaining Background Checks and Investigations by Employers. For information on investigative consumer reports, see Obtaining Investigative Consumer Reports.

    This form is not intended for use if you are hiring in San Francisco or the City of Los Angeles; these cities are covered by the San Francisco Fair Chance Ordinance or the Los Angeles Fair Chance Initiative in Hiring Ordinance.​​​​​

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  • Notice to Employee as to Change in Relationship - Spanish

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    Use this form to notify an employee of a change in the employment relationship, such as a layoff or termination.

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  • Notice to Employee: Government Inspection of Employment Eligibility Records - Spanish

    Free

    ​If you receive a Notice of Inspection from a federal immigration enforcement agency, such as Immigration and Custom Enforcement (ICE), you must provide notice to all employees by posting this Notice to Employee (Labor Code section 90.2) in your workplace within 72 hours of receiving the Notice of Inspection. You must also post a copy of the Notice of Inspection along with this form and provide a copy of the Notice of Inspection to an employee upon reasonable request.

    In addition, you are required to: (1) post this notice in any language you normally use to communicate employment-related information to the employee; and (2) provide a copy of this notice to the employees’ exclusive collective bargaining representative(s), if any.​

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  • Overtime Request - Spanish

    Provide this form to supervisors, managers and employees and train all employees in the use of this form whenever overtime work is needed or performed.

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  • Personal Chiropractor or Acupuncturist Designation Form - Spanish

    Give this form to any employee who wants to pre-designate a chiropractor or acupuncturist as treating doctor for work-related injuries.

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  • Personal Physician Designation Form - Spanish

    Give this form to every employee prior to the end of the first payroll period following initial employment. It may be given as part of the Workers' Compensation Information Pamphlet, which must be provided at that time. The form must also be given to any employee who wants to pre-designate a personal physician (M.D., D.O. or medical group) as treating doctor for a work-related injury, upon request, at any time during employment.​

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  • Pregnancy Disability Leave Notice - 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. This notice applies to California employers with 5 or more employees. You must post this notice in a place commonly used by employees, such as a break room. This notice is also part of the California and Federal Employment Notices Poster available at the CalChamber Store.​

    According to the Department of Fair Employment and Housing, you may post any version of the Rights and Obligations as a Pregnant Employee notice (DFEH-100-20​) from April 2016 to the present.

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  • Request for Leave of Absence - FMLA CFRA PDL - Spanish

    Provide this form if you're an employer covered by the federal Family and Medical Leave Act (FMLA) or the California Family Rights Act (CFRA) and either an employee has requested a leave of absence or you recognize the need.

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  • Training Sign-In Sheet - Spanish

    Use this sign-in sheet to document and verify which employees attend training. Employers not fluent in Spanish should refer to the English version to complete this form properly. Keep the signed form in the employee's personnel file.

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  • Unemployment Insurance Benefit Table - Spanish

    Review this chart to determine the employee’s quarterly wage during the employment base period and the corresponding weekly benefit amount.

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  • W4 - Employees Withholding Allowance Certificate - Spanish

    Free

    Use this required form to obtain information from an employee to determine the correct Federal income tax amount to withhold from his/her paychecks. ​​

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  • Wage Order 01 - Manufacturing - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 1 regulates wages, hours, and working conditions in the Manufacturing Industry.

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  • Wage Order 02 - Personal Services - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 2 regulates wages, hours and working conditions in the Personal Services Industry.

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  • Wage Order 03 - Canning Freezing and Preserving - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 3 regulates wages, hours and working conditions in the Canning, Freezing and Preserving Industry.​

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  • Wage Order 04 - Professional Technical Clerical Mechanical and Similar Occupations - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 4 regulates wages, hours and working conditions in the Professional, Technical, Clerical, Mechanical and Similar Occupations.

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  • Wage Order 05 - Public Housekeeping - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 5 regulates wages, hours and working conditions in the ​Public Housekeeping Industry.

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  • Wage Order 06 - Laundry Linen Supply Dry Cleaning and Dyeing - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 6 regulates wages, hours and working conditions in the Laundry, Linen Supply, Dry Cleaning ​and Dyeing Industry.

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  • Wage Order 07 - Mercantile - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 7 regulates wages, hours and working conditions in the Mercantile Industry.

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  • Wage Order 08 - Industries Handling Products After Harvest - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 8 regulates wages, hours and working conditions in industries handling products after harvest.

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  • Wage Order 09 - Transportation - Spanish

    ​California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 9 regulates wages, hours and working conditions in the Transportation Industry.

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  • Wage Order 10 - Amusement and Recreation - Spanish

    ​California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 10 regulates wages, hours and working conditions in the Amusement and Recreation Industry.

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  • Wage Order 11 - Broadcasting - Spanish

    ​California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 11 regulates wages, hours and working conditions in the Broadcasting Industry.

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  • Wage Order 12 - Motion Picture Industry - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 12 regulates wages, hours and working conditions in the Motion Picture Industry.​

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  • Wage Order 13 - Industries Preparing Agricultural Products for Market, on the Farm - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 13 regulates wages, hours and working conditions in industries preparing agricultural products for market, on the farm.

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  • Wage Order 15 - Household Occupations - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 15 regulates wages, hours and working conditions in household occupations.

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  • Wage Order 16 - On-site Construction Drilling Logging and Mining - Spanish

    ​California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of nonexempt employees in California. Order 16 regulates wages, hours and working conditions in the On-site Construction, Drilling, Logging and Mining Industries.

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  • Wage Order 17 - Miscellaneous Employees - Spanish

    California’s Industrial Welfare Commission (IWC) Wage Orders regulate wages and hours of non-exempt employees in California. Order 17 regulates wages, hours, and working conditions for miscellaneous employees.

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  • Workers' Compensation Claim Form - DWC 1 - Spanish

    Free

    If an employee suffers a work-related injury or illness, he or she may be entitled to workers' compensation benefits. Give this form to the employee and have him /her complete the "Employee" section and then return the form to you. Give the employee the copy marked "Employee's Temporary Receipt," providing the employee with a dated copy when you have completed the form. All employees should also have received a pamphlet describing workers' compensation benefits and procedures to obtain them.​​ This form has been made available by the Department of Industrial Relations for use with non-English speaking employees.

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