FORMS FOR
Updated 02.23.15 (Always use the most recent version of the forms.)
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.
Absence Analysis Calendar (AAC):
Accident to Employee Under Worker's Compensation Act, Report of (EB-49, r. 03/14): Instructions (r. 03/14) / EB-49 Form
Application for Funeral Leave (CBP-155, R 10/05): MS Word / Adobe PDF
Application for Injury Pay / Worker's Compensation Benefit (CBP-156A, R. 12/12): MS Word / Adobe PDF
Application for Sick Leave (CBP-156, R 3/14), Absence Due to Personal Illness: MS Word / Adobe PDF
Automobile Allowance Form (Private) Information Sheet (CBP-138): MS Word / Adobe PDF
Authorization for Travel Advance (CBP-210, R 10/05): MS Word
Biweekly Commuting Miles, City of Milwaukee (CBP-194R, R. 01/00): MS Word / Adobe PDF
Budget Administration Forms (you will be redirected to the MINT)
Classification Related Forms and Guidelines
Complaint Form, Employee (for use by City employees only) (R. 10/09): Adobe PDF
Daily Report of "Time Off" Worked or Taken Off (CBP-171) MS Word / Adobe PDF
Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
Discipline and Grievance Procedure for General City Employees (R. 02.23.15): Adobe PDF
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)
Disciplinary Reduction (Demotion) Notice (CS-113, R 2/12): MS Word / Adobe PDF
Direct Deposit Form (C-457R4, 04/2006): Adobe PDF
Discharge Notice (CS-81, R 2/12): MS Word / Adobe PDF
Donor Leave Program (Accrued Time Off Donor Program and Forms)
Equal Rights Commission Complaint Form: coming soon
Expenses Incurred, Statement of (CBP-211, R 10/05): MS Word / Adobe PDF
Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
Flexible Choices Program Forms and Information
FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
FMLA Related Forms and Information (r. 4/30/14): click here
Funeral Leave, Application for (CBP-155, R 10/05)
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
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
Grievance Procedure, Workplace Safety (General City) (R. 10/11): click here
Health Enrollment Form: MS Word / Adobe PDF (click here for instructions)
Hiring Checklist (R 08.23.13): Adobe PDF
Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12):
I-9 Form and Instructions
Job Description (CS-25, R. 12/09): http://city.milwaukee.gov/der/JobDescriptions
Job Performance Improvement Plan, Employee: MS Word / Adobe PDF
Jury Duty, Application for (C-139RS, R 4/05)
Leave of Absence, Request for (CBP-129, R 11/10): MS Word / Adobe PDF
Long-Term Disability Forms and Information
Management Performance Planning and Review Forms (Employee Job Performance Plan, Sample Competencies)
Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13):
New Employee Orientation Forms and Information (you will be redirected to the MINT)
Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
Personnel Requisition/Request to Fill (BMD-1): MS Excel
Probationary Service, Report on (CS-58, R 7/13): MS Word / Adobe PDF
Procurement Forms (you will be redirected to the MINT)
Professional Development Award Application (R. 5.27.14): MS Word / Adobe PDF
Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01): MS Word / Adobe PDF
Provisional Appointee Statement of Understanding (r. 09/14) -- coming soon
Reinstatement, Request for (R 12/13): MS Word / Adobe PDF
A Reinstatement Job Application must also be completed and attached to the Request for Reinstatement.
- Click here to download the job application form, R 12/13) (Adobe PDF only).
Removal from Eligible List (Appeal Form): MS Word / Adobe PDF
Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF
Request for Optional Holiday (06.12.14): MS Word / Adobe PDF
Request for Selective Certification Authorization (CS-64, R 11/06): MS Word / Adobe PDF
Request for W-2 Form (C-403 r6, R 3/08): MS Word / Adobe PDF
Residency Related Forms:
Resignation Form (CBP-123, R 10/07): MS Word / Adobe PDF
Safety Glass Prescription Order Form (R 02/10) -- (you will be redirected to the MINT)
Safety Orientation Checklist: Adobe PDF
Selective Certification Authorization, Request for (CS-64, R 11/06): MS Word / Adobe PDF
Sick Leave (Medical) Certification (CBP-157, R. 03/14/14): Adobe PDF
Sick Leave, Application for (CBP-156, R. 3/14/14), Absence Due to Personal Illness: MS Word / Adobe PDF
Statement of Economic Interest
Statement of Expenses Incurred for City of Milwaukee (CBP-211, R. 10/05): MS Word
Suspension Notice (CS-82, R 2/12): MS Word / Adobe PDF
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.
Temporary Appointment Forms (Memo to Departments; 09.04.14)
Termination Notice (CS-80, R 2/12): MS Word / Adobe PDF
Training Enrollment Form (only to be used by departmental Training Information Coordinators for courses listed in the DER Training Bulletin): MS Word / Adobe PDF
Travel Advance, Authorization for (CBP-210, R 10/05): MS Word
Tuition Benefit/Reimbursement Application Process and Guidelines
Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF
Waiver Form (Health/Dental): Adobe PDF
Worksite Assessment Form (R 11/05): Adobe PDF
Written Warning (CS-79, R 8/12): MS Word / Adobe PDF
W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF
WT-4 Form (R 01/14) Employees Withholding Exemption Certificate /New Hire Reporting: Adobe PDF