FORMS FOR
:
► Revised 09.21.16: Professional Development Award Application (#45 in list)
► Revised 03.18.16 (posted 08.03.16): Safety Glass Order Form
► Revised 08.02.16: Resignation Form (CBP-123)
► Revised 08.02.16: Termination Notice (CS-80)
► Revised 08.02.16: Discharge Notice (CS-81)
► Revised 08.02.16: Suspension Notice (CS-82)
► Revised 05.31.16: Grievance Initiation, Disciplinary Procedure for General City Employees
► Revised 05.31.16: Disciplinary Reduction Notice (Demotion) (CS-113)
► NEW FORM 04.20.16: Separation Notice (non-disciplinary)
Questions? Send email to jkamme@milwaukee.gov.
IMPORTANT! Most of the Microsoft Word documents are formatted with fillable fields. Open the document in Microsoft Word, move your cursor to the first box or "field." Type the information and press the "tab" key to move to the next box (the row will expand as you type). For a check box, type an "x" or click the check box. (The MS Word versions are not meant to be completed by hand or on a typewriter.) If you prefer to complete a form by hand or on a typewriter, print then complete the Adobe PDF version.
1. Absence Analysis Calendar (AAC):
2. Accident to Employee Under Worker's Compensation Act, Report of (EB-49, r. 03/14):
Instructions (r. 03/14) / EB-49 Form
5. Automobile Allowance Form (Private) Information Sheet (CBP-138): MS Word / Adobe PDF
6. Beneficiary Change Form (Active Employees), Pension and Life Insurance:
http://www.cmers.com/Library/Forms.htm
7. Biweekly Commuting Miles, City of Milwaukee (CBP-194R, R. 01/00): MS Word / Adobe PDF
8. Budget Administration Forms (you will be redirected to the MINT)
9. Classification Related Forms and Guidelines
10. Complaint Form, Employee (for use by City employees only) (R. 10/09): Adobe PDF
11. Daily Report of "Time Off" Worked or Taken Off (CBP-171) MS Word / Adobe PDF
12. Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
13. Dental Enrollment Form: MS Word / Adobe PDF
14. Discipline and Grievance Procedure for General City Employees (R. 05.05.16): Adobe PDF
15. Disciplinary Appeals to the City Service Commission, Guidelines for (R. 10.21.14)
- Appeal Form: MS Word (formatted as a fill-in form) / Adobe PDF (to be completed by hand)
16. Disciplinary Reduction (Demotion) Notice (CS-113, R 05.31.16): MS Word / Adobe PDF
17. Direct Deposit Form (C-457R4, 04/2006)
18. Discharge Notice (CS-81, R 08.02.16): MS Word / Adobe PDF
19. Employee Assessment Form (01.06.16) - You will be redirected to the Pay Progression Toolkit
20. Equal Rights Commission Complaint Form: coming soon
21. Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
22. Flexible Choices Program Forms and Information (2016)
23. FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
24. FMLA Toolkit: Forms, Policy and Information
23. Funeral Leave, Application for (CBP-155, R 10/05)
26. Furlough, Mandatory:
- Payroll Reporting Form for Hours in Mandatory Furlough Week (FRL-1; 3/26/12): MS Word / Adobe PDF
- Policy and Administrative Guidelines: Adobe PDF
27. Grievance Forms:
- Grievance Form, Fire Department (CC-233, R. 11/07): MS Word / Adobe PDF
- Grievance Form, Fire Department, Bureau of Construction and Maintenance (CC-234, R. 11/07): MS Word / Adobe PDF
28. Grievance Procedure, Workplace Safety (General City) (R. 10/11): click here
29. Health Enrollment Form: MS Word / Adobe PDF (click here for instructions)
30. Hiring Checklist (R 08.23.13): Adobe PDF
31. Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12)
32. I-9 Form and Instructions
33. Job Description (CS-25, R. 12/09): http://city.milwaukee.gov/der/JobDescriptions
34. Jury Duty, Application for (C-139RS, R 4/05)
35. Leave of Absence, Request for (CBP-129, R. 03.14.16): MS Word / Adobe PDF
36. Long-Term Disability Forms and Information (2015) / Long-Term Disability Forms and Information (2016)
37. Management Performance Planning and Review Forms (Employee Job Performance Plan, Sample Competencies)
38. Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13):
39. New Employee Orientation Forms and Information (r. 12.14.15) (you will be redirected to the MINT)
40. Pay Progression Toolkit
41. Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
42. Performance Improvement Plan (PIP)
43. Probationary Service, Report on (CS-58, R 7/13): MS Word / Adobe PDF
44. Procurement Forms (you will be redirected to the MINT)
45. Professional Development Award Application (R. 9.21.16): MS Word / Adobe PDF
46. Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01):
MS Word / Adobe PDF
47. Provisional Appointee Statement of Understanding (r. 09/14) -- coming soon
48. Reinstatement, Request for (R 12/13): To request Reinstatement print and complete both of the following forms:
- Request for Reinstatement (includes MPS) (not for use by Fire or Police)
- Reinstatement Job Application
- If you have been separated from City service for less than 1 year, submit the required documents to: DER-Certification Section, ATTN: Karen Kamlah, City Hall, Room 706, Milwaukee WI 53202-3515.
- If you have been separated from City service for more than 1 year, submit the required documents to: City Service Commission, ATTN: Nola Nelson, City Hall, Room 706, Milwaukee WI 53202-3515.
49. Removal from Eligible List (Appeal Form): MS Word / Adobe PDF
50. Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
51. Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF
52. Request for Optional Holiday (06.12.14): MS Word / Adobe PDF
53. Request for Selective Certification Authorization (CS-64, R 11/06): MS Word / Adobe PDF
54. Request for W-2 Form (C-403 r6, R 3/08): MS Word / Adobe PDF
55. Residency Related Forms:
56. Resignation Form (CBP-123, R. 08.02.16): MS Word / Adobe PDF
57. Safety Glass Prescription Order Form (R. 03.18.16) -- (you will be redirected to the MINT)
58. Safety Orientation Checklist: Adobe PDF
59. Selective Certification Authorization, Request for (CS-64, R 11/06): MS Word / Adobe PDF
60. Separation Notice (non-disciplinary) (04.20.16): MS Word / Adobe PDF
61. Sick Leave, Application for (CBP-156, R. 3/14/14), Absence Due to Personal Illness: MS Word / Adobe PDF
62. Sick Leave (Medical) Certification (CBP-157, R. 03/14/14): Adobe PDF
63. Statement of Economic Interest
64. Suspension Notice (CS-82, R 08.02.16): MS Word / Adobe PDF
65. Temporary or Provisional Appointees Statement of Understanding (CS-114, R 3/07) The Temporary Appointment and Provisional Appointment are now separate forms. The "Provisional Appointee Statement of Understanding" will be posted soon. In the meantime, use the CS-114 FORM (click here) only for Provisional Appointments until the revised form is available. For Temporary Appointments, please see the memo below) and use the 2 forms that follow.
66. Temporary Appointment Forms (Memo to Departments; 09.04.14)
67. Termination Notice (CS-80, R 08.02.16): MS Word / Adobe PDF
68. Training Enrollment Form (only to be used by departmental Training Information Coordinators for courses listed in the DER Training Bulletin): MS Word / Adobe PDF
69. Travel Expense Forms and Guidelines (you will be redirected to the MINT)
- CPB-210: Authorization for Travel Advance
- CBP-211: Statement of Expenses Incurred
- CTE-001: Conference and Training Evaluation
- TRF-001: Request for Travel on Behalf of City of Milwaukee
- Travel Policy Overview
- Travel Guidelines
70. Tuition Benefit (Reimbursement) Application Instructions and Administrative Guidelines
71. Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
72. Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF
73. Waiver Form (Health/Dental): Adobe PDF
74. Worksite Assessment Form (R 11/05): Adobe PDF
75. Written Warning (CS-79, R 10.14.15): MS Word / Adobe PDF
76. W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF
77. W-4 Form (2016): Adobe PDF
78. WT-4 Form (R 01/14) Employees Withholding Exemption Certificate /New Hire Reporting: Adobe PDF