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FORMS FOR CITY OF MILWAUKEE EMPLOYEES

Updated 09.08.14  (Always use the most recent version of the forms.)

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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 Calendars (AAC): (For questions/comments regarding the AAC, please send an e-mail to tbiern@milwaukee.gov.)
     
  2. Accident to Employee Under Worker's Compensation Act, Report of (EB-49, r. 03/14):  Instructions (r. 03/14) / EB-49 Form
  3. Accrued Time Off Donor Program and Forms
  4. Application for Funeral Leave (CBP-155, R 10/05): MS Word / Adobe PDF
  5. Application for Injury Pay / Worker's Compensation Benefit (CBP-156A, R. 12/12):  MS Word / Adobe PDF
  6. Application for Sick Leave (CBP-156, R  3/14), Absence Due to Personal Illness:  MS Word  / Adobe PDF
  7. Appeal Forms:
  8. Automobile Allowance Form (Private) Information Sheet (CBP-138): MS Word  /  Adobe PDF
  9. Authorization for Travel Advance (CBP-210, R 10/05): MS Word
  10. Biweekly Commuting Miles, City of Milwaukee (CBP-194R, R. 01/00):  MS Word  /  Adobe PDF
  11. Budget Administration Forms (must have MINT access): click here
  12. Classification Related Forms and Guidelines: click here
  13. Complaint Form, Employee (for use by City employees only) (R. 10/09):  Adobe PDF
  14. Daily Report of "Time Off" Worked or Taken Off (CBP-171)  MS Word Adobe PDF
  15. Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
  16. Discipline and Grievance Procedure for General City Employees (R. 3/31/14): Adobe PDF
  17. Disciplinary Reduction (Demotion) Notice (CS-113, R 2/12): MS Word / Adobe PDF
  18. Direct Deposit Form (C-457R4, 04/2006):  Adobe PDF
  19. Discharge Notice (CS-81, R 2/12): MS Word / Adobe PDF
  20. Donor Leave Program (Accrued Time Off Donor Program and Forms)
  21. Equal Rights Commission Complaint Form: not available at this time
  22. Expenses Incurred, Statement of (CBP-211, R 10/05): MS Word / Adobe PDF
  23. Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
  24. Flexible Choices Program Forms and Information
  25. FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
  26. FMLA Related Forms and Information (r. 4/30/14):  click here
  27. Funeral Leave, Application for (CBP-155, R 10/05): MS Word / Adobe PDF  -- click here for guidelines
  28. 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
  29. 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
  30. Grievance Procedure, Workplace Safety (General City) (R. 10/11):  click here
  31. Health Enrollment Form:  MS Word /  Adobe PDF  (click here for instructions)
  32. Hiring Checklist (R 08.23.13): Adobe PDF
  33. Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12):  MS Word / Adobe PDF
  34. I-9 Form and Instructions
  35. Job Description (CS-25, R. 12/09): click here
  36. Job Performance Improvement Plan, Employee: MS Word / Adobe PDF
  37. Jury Duty, Application for (C-139RS, R 4/05)
  38. Leave of Absence, Request for (CBP-129, R 11/10): MS Word / Adobe PDF
  39. Long-Term Disability Forms and Information
  40. Management Performance Planning and Review Forms: click here to access the forms listed below
    • Employee Job Performance Plan, Sample Competencies
  41. Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13): MS Word / Adobe PDF
  42. New Employee Orientation Forms and Information (you will be redirected to the MINT)
  43. Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
  44. Personnel Requisition/Request to Fill (BMD-1): MS Excel
  45. Probationary Service, Report on (CS-58, R 7/13): MS Word / Adobe PDF
  46. Procurement Forms: click here to be redirected to the MINT
  47. Professional Development Award Application (R. 5.27.14):  MS Word  /  Adobe PDF
  48. Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01): MS Word / Adobe PDF
  49. Provisional Appointee Statement of Understanding (r. 09/14) -- coming soon
  50. Reinstatement, Request for (R 12/13):   MS WordAdobe 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).
  51. Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
  52. Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF
  53. Request for Optional Holiday (06.12.14):  MS Word  /  Adobe PDF
  54. Request for Selective Certification Authorization (CS-64, R 11/06):  MS Word / Adobe PDF
  55. Request for W-2 Form (C-403 r6, R 3/08): MS Word / Adobe PDF  
  56. Residency Related Forms:
  57. Resignation Form (CBP-123, R 10/07): MS Word / Adobe PDF
  58. Safety Glass Prescription Order Form (R 02/10):  click here (you will be redirected to the MINT)
  59. Safety Orientation Checklist: Adobe PDF
  60. Selective Certification Authorization, Request for (CS-64, R 11/06):  MS Word / Adobe PDF
  61. Self-Service Instructions and Information: click here
  62. Sick Leave (Medical) Certification (CBP-157, R. 03/14/14):  Adobe PDF 
  63. Sick Leave, Application for (CBP-156, R. 3/14/14), Absence Due to Personal Illness:  MS Word  /  Adobe PDF
  64. Statement of Economic Interest
  65. Statement of Expenses Incurred for City of Milwaukee (CBP-211, R. 10/05): MS Word
  66. Suspension Notice (CS-82, R 2/12): MS Word  Adobe PDF
  67. Temporary or Provisional Appointees Statement of Understanding (CS-114, R 3/07) The form CS-114 is no longer in use.  The Temporary Appointment and Provisional Appointment are now separate forms.  The "Provisional Appointee Statement of Understanding" will be posted shortly.
  68. Temporary Appointment Forms: click here for Memo to Departments (09.04.14)
  69. Termination Notice (CS-80, R 2/12): MS Word / Adobe PDF
  70. Training Enrollment Form (only to be used by departmental Training Information Coordinators for courses listed in the DER Training Bulletin)MS Word / Adobe PDF
  71. Travel Advance, Authorization for (CBP-210, R 10/05): MS Word
  72. Tuition Benefit/Reimbursement Application Process and Guidelines  
  73. Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
  74. Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF
  75. Waiver Form (Health/Dental): Adobe PDF
  76. Worksite Assessment Form (R 11/05): Adobe PDF
  77. Written Warning (CS-79, R 8/12): MS Word / Adobe PDF
  78. W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF  
  79. W-4 Form (2014): Adobe PDF
  80. WT-4 Form (R 01/14) Employees Withholding Exemption Certificate /New Hire Reporting:  Adobe PDF

 

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Contact Us

City Hall
200 E. Wells Street, Room 706
Milwaukee, WI 53202-3515

Hours of Business
8:00 am - 4:45 pm
Monday - Friday

General Information
(414) 286-3751
emprel@milwaukee.gov

Job Information
(414) 286-5555
StaffingInfo@milwaukee.gov
www.milwaukee.gov/jobs

Benefits / ACTIVE Employees
(414) 286-3184
DerBenefits@milwaukee.gov
www.milwaukee.gov/benefits
www.milwaukee.gov/benefits2015

Benefits / RETIRED Employees
(414) 286-3557
norm@cmers.com
www.cmers.com

TDD: (414) 286-2960