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FORMS FOR CITY SERVICE

REVISED or ADDED in 2016:

 

      ► Revised 10.07.16: Notification of Intent to Donat e Time (see #3 in list)
      ► 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.  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)

15.  Disciplinary Reduction (Demotion) Notice (CS-113, R 05.31.16): MS Word / Adobe PDF


16.  Direct Deposit Form (C-457R4, 04/2006)


17.  Discharge Notice (CS-81, R 08.02.16): MS Word / Adobe PDF


18.  Employee Assessment Form (01.06.16) - You will be redirected to the Pay Progression Toolkit


19.  Equal Rights Commission Complaint Form: coming soon


20.  Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF


21.  Flexible Choices Program Forms and Information (2016)


22.  FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF


23.  FMLA Toolkit: Forms, Policy and Information


24.  Funeral Leave, Application for (CBP-155, R 10/05)


25.  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

26.  Health Enrollment Form:  MS Word /  Adobe PDF  (click here for instructions)


27.  Hiring Checklist (R 08.23.13): Adobe PDF


28.  Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12)


29.  I-9 Form and Instructions


30.  Job Description (CS-25, R. 12/09):   http://city.milwaukee.gov/der/JobDescriptions


31.  Jury Duty, Application for (C-139RS, R 4/05)


32.  Leave of Absence, Request for (CBP-129, R. 03.14.16): MS Word / Adobe PDF


33.  Long-Term Disability Forms and Information: 2016  /  2017


34.  Management Performance Planning and Review Forms (Employee Job Performance Plan, Sample Competencies)


35.  Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13):


36.  New Employee Orientation Forms and Information:


37.  Pay Progression Toolkit


38.  Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF


39.  Performance Improvement Plan (PIP)


40.  Probationary Service, Report on (CS-58, R 7/13): MS Word / Adobe PDF


41.  Procurement Forms (you will be redirected to the MINT)


42.  Professional Development Award Application (R. 9.21.16):  MS Word  /  Adobe PDF


43.  Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01):
       MS Word / Adobe PDF


44.  Provisional Appointee Statement of Understanding (r. 09/14) -- coming soon


45.  Reinstatement, Request for (R 12/13):  To request Reinstatement print and complete both of the following forms:

  1. Request for Reinstatement (includes MPS) (not for use by Fire or Police)
  2. 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.

46.  Removal from Eligible List (Appeal Form):  MS Word / Adobe PDF


47.  Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF


48.  Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF


49.  Request for Optional Holiday (06.12.14):  MS Word  /  Adobe PDF


50.  Request for Selective Certification Authorization (CS-64, R 11/06):  MS Word / Adobe PDF


51.  Request for W-2 Form (C-403 r6, R 3/08): MS Word / Adobe PDF


52.  Residency Related Forms:


53.  Resignation Form (CBP-123, R. 08.02.16): MS Word / Adobe PDF


54.  Safety Glass Prescription Order Form (R. 03.18.16) -- (you will be redirected to the MINT)


55.  Safety Orientation Checklist: Adobe PDF


56.  Selective Certification Authorization, Request for (CS-64, R 11/06):  MS Word / Adobe PDF


57.  Separation Notice (non-disciplinary)  (04.20.16):  MS Word  /  Adobe PDF


58.  Sick Leave, Application for (CBP-156, R. 3/14/14), Absence Due to Personal Illness:  MS Word  /  Adobe PDF


59.  Sick Leave (Medical) Certification (CBP-157, R. 03/14/14):  Adobe PDF


60.  Statement of Economic Interest


62.  Suspension Notice (CS-82, R 08.02.16): MS Word  Adobe PDF


62.  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.


63.  Temporary Appointment Forms (Memo to Departments; 09.04.14)


64.  Termination Notice (CS-80, R 08.02.16): MS Word / Adobe PDF


65.  Training Enrollment Form (only to be used by departmental Training Information Coordinators for courses listed in the DER Training Bulletin)MS Word / Adobe PDF


66.  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

67.  Tuition Benefit (Reimbursement) Application Instructions and Administrative Guidelines


68.  Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF


69.  Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF


70.  Waiver Form (Health/Dental): Adobe PDF


72.  Worksite Assessment Form (R 11/05): Adobe PDF


73.  Written Warning (CS-79, R 10.14.15): MS Word / Adobe PDF


74.  W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF


75.  W-4 Form (2016):  Adobe PDF


75.  WT-4 Form (R 01/14) Employees Withholding Exemption Certificate /New Hire Reporting:  Adobe PDF

Contact Us

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

City offices are closed December 23, 26, 30 and January 2.

 

General Information
(414) 286-3751
(414) 286-5555 (job hotline)
(414) 286-2960 (TDD)
Email