Forms for City Employees

Updated 11/18/13   Refresh/reload this page often. Questions? Click here to send an Email message.

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Most of the Microsoft Word forms are formatted with fields.  You must type directly on the form.  Open the document, move your cursor to the first box or "field." Type the information and press the "tab" key to move to the next box (the box will expand as you type). Type an "x" or click in a check box.   If you prefer to complete a form by hand, print and complete the Adobe PDF version.  

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  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 10/06): MS Word   (Click here for instructions regarding the EB-49 form; R 10/05)
  3. Accrued Time Off Donor Program and Forms:  click here
  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 12/12), 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. Coaching Services Enrollment Form:  click here
  15. Daily Report of "Time Off" Worked or Taken Off (CBP-171)  MS Word  /  Adobe PDF
  16. Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
  17. Dental Enrollment Form: MS Word / Adobe PDF
  18. Discipline and Grievance Procedure for General City Employees (R. 5/13): Adobe PDF
  19. Disciplinary Reduction (Demotion) Notice (CS-113, R 2/12): MS Word / Adobe PDF
  20. Direct Deposit Form (C-457R4, 04/2006):  Adobe PDF
  21. Discharge Notice (CS-81, R 2/12): MS Word / Adobe PDF
  22. Donor Leave Program (Accrued Time Off Donor Program and Forms): click here
  23. Equal Rights Commission Complaint Form: not available at this time
  24. Expenses Incurred, Statement of (CBP-211, R 10/05): MS Word / Adobe PDF
  25. Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
  26. Flexible Choices Program Forms and Information:  http://city.milwaukee.gov/der/Benefits2013/FSA.htm 
  27. FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
  28. FMLA Related Forms and Information:  click here
  29. Funeral Leave, Application for (CBP-155, R 10/05): MS Word / Adobe PDF  -- click here for guidelines
  30. 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
  31. 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
  32. Grievance Procedure, Workplace Safety (General City) (R. 10/11):  click here
  33. Health Enrollment Form:  MS Word /  Adobe PDF  (click here for instructions)
    • Click here for 2013 Health Insurance Information.
  34. Hiring Checklist (R 5/11): Adobe PDF
  35. Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12):  MS Word / Adobe PDF
  36. I-9 Form and Instructions: click here
  37. Job Description (CS-25, R. 12/09): click here
  38. Job Performance Improvement Plan, Employee: MS Word / Adobe PDF
  39. Jury Duty, Application for (C-139RS, R 4/05): click here
  40. Leave of Absence, Request for (CBP-129, R 11/10): MS Word / Adobe PDF
  41. Long-Term Disability Forms and Information:  http://city.milwaukee.gov/der/Benefits2013/LTD.htm 
  42. Management Performance Planning and Review Forms: click here to access the forms listed below
    • Employee Job Performance Plan, Sample Competencies
  43. Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13): MS Word / Adobe PDF
  44. New Employee Orientation Forms and Information: click here (you will be redirected to the MINT)
  45. Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
  46. Personnel Requisition/Request to Fill (BMD-1): MS Excel
  47. Probationary Service, Report on (CS-58, R 7/13): MS Word / Adobe PDF
  48. Procurement Forms: click here to be redirected to the MINT
  49. Professional Development Award Application (R. 9/27/13):  MS Word  /  Adobe PDF
  50. Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01): MS Word / Adobe PDF
  51. Reinstatement, Request for (R 02/08): 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 (Adobe PDF only).
  52. Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
  53. Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): 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. Savings Bonds:  Discontinuation of Program (click here for more information)
  59. Safety Glass Prescription Order Form (R 02/10):  click here (you will be redirected to the MINT)
  60. Safety Orientation Checklist: Adobe PDF
  61. Selective Certification Authorization, Request for (CS-64, R 11/06):  MS Word / Adobe PDF
  62. Self-Service Instructions and Information: click here
  63. Sick Leave (Medical) Certification (CBP-157, R. 1/8/13):  MS Word  /  Adobe PDF 
  64. Sick Leave, Application for (CBP-156, R 12/12), Absence Due to Personal Illness:  MS Word  /  Adobe PDF
  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): MS Word / Adobe PDF
  68. Termination Notice (CS-80, R 2/12): MS Word / Adobe PDF
  69. Training Enrollment Form-2013 (only to be used by the Training Information Coordinator for courses listed in the DER Training Bulletins):  MS Word / Adobe PDF
  70. Travel Advance, Authorization for (CBP-210, R 10/05): MS Word
  71. Tuition Benefit/Reimbursement Application Process and Guidelines (click here)
  72. Pre-Approval Request Form for Debits to the Tuition Benefit Account for Department-Initiated Training (R. 6/7/13):  MS Word / Adobe PDF
    • Employees:  Please do not complete or sign this form.  It is to be initiated at the department's discretion. A department may request to debit the Tuition Reimbursement Special Purpose Account for department-initiated training in cases where a City department paid a vendor directly and is asking Employee Relations for a credit from the Tuition Reimbursement Special Purpose Account.  These requests would be appropriate if the cost of the training represents a significant expense to the employee.
  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 (2013): Adobe PDF
  80. WT-4 Form (R 05/08) Employees Withholding Exemption Certificate /New Hire Reporting:  Adobe PDF

 

The Department of Employee Relations will be closed on:

  • Tuesday, December 24
  • Wednesday, December 25
  • Tuesday, December 31
  • Wednesday, January 1