Forms for City Employees

Updated 05/10/13   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 you must use 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. Authorization for Travel Advance (CBP-210, R 10/05): MS Word
  9. Biweekly Commuting Miles, City of Milwaukee (CBP-194R, R. 01/00):  MS Word  /  Adobe PDF
  10. Budget Administration Forms (must have MINT access): click here
  11. Classification Related Forms and Guidelines: click here
  12. Complaint Form, Employee (for use by City employees only) (R. 10/09):  Adobe PDF
  13. Daily Automobile Allowance Record (CBP-139, R 2/00): MS Word / Adobe PDF
  14. Dental Enrollment Form: MS Word / Adobe PDF
  15. Discipline and Grievance Procedure for General City Employees (R. 5/13): Adobe PDF
  16. Disciplinary Reduction (Demotion) Notice (CS-113, R 2/12): MS Word / Adobe PDF
  17. Direct Deposit Form (C-457R4, 04/2006):  Adobe PDF
  18. Discharge Notice (CS-81, R 2/12): MS Word / Adobe PDF
  19. Donor Leave Program (Accrued Time Off Donor Program and Forms): click here
  20. Equal Rights Commission Complaint Form: Adobe PDF
  21. Expenses Incurred, Statement of (CBP-211, R 10/05): MS Word / Adobe PDF
  22. Favorable Occurance Commendation (CS-77, R 3/07): MS Word / Adobe PDF
  23. Flexible Choices Program Forms and Information:  http://city.milwaukee.gov/der/Benefits2013/FSA.htm 
  24. FLSA Exemption Worksheet (all tests): MS Word / Adobe PDF
  25. FMLA Related Forms and Information:  click here
  26. Funeral Leave, Application for (CBP-155, R 10/05): MS Word / Adobe PDF
  27. 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
  28. 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
  29. Grievance Procedure, Workplace Safety (General City) (R. 10/11):  click here
  30. Health Enrollment Form:  MS Word /  Adobe PDF  (click here for instructions)
    • Click here for 2013 Health Insurance Information.
  31. Hiring Checklist (R 5/11): Adobe PDF
  32. Injury Pay / Worker's Compensation Benefit, Application for (CBP-156A, R. 12/12):  MS Word / Adobe PDF
  33. I-9 Form and Instructions: click here
  34. Job Description (CS-25, R. 12/09): click here
  35. Job Performance Improvement Plan, Employee: MS Word / Adobe PDF
  36. Jury Duty, Application for (C-139RS, R 4/05): click here
  37. Leave of Absence, Request for (CBP-129, R 11/10): MS Word / Adobe PDF
  38. Long-Term Disability Forms and Information:  http://city.milwaukee.gov/der/Benefits2013/LTD.htm 
  39. Management Performance Planning and Review Forms: click here to access the forms listed below
    • Employee Job Performance Plan, Sample Competencies
  40. Military Training Leave, Riot or Civil Disturbance Duty, Pay Request for (CS-11, R. 4/13): MS Word / Adobe PDF
  41. New Employee Orientation Forms and Information (can only be accessed via the City's Intranet):  Go to http://mint.milwaukee.gov and click on Employee Resources, then on New Employee Orientation.
  42. Payroll Deduction Authorization (CBP-112R, R 4/07): MS Word / Adobe PDF
  43. Personnel Requisition/Request to Fill (BMD-1): MS Excel
  44. Probationary Service, Report on (CS-58, R 4/08): MS Word / Adobe PDF
  45. Procurement Forms (must have MINT access) : click here
  46. Professional Development Award (R. 2/27/13):  MS Word  /  Adobe PDF
  47. Promotion without Competitive Examination (Rule IV, Sect. 9), Request for (CS-92, R 8/01): MS Word / Adobe PDF
  48. 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).
  49. Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
  50. Request for Military Training Leave, Riot or Civil Disturbance Duty (CS-11, R 9/02; pg 2 R 11/03): MS Word / Adobe PDF
  51. Request for Selective Certification Authorization (CS-64, R 11/06):  MS Word / Adobe PDF
  52. Request for W-2 Form (C-403 r6, R 3/08): MS Word / Adobe PDF  
  53. Residency Related Forms:
  54. Resignation Form (CBP-123, R 10/07): MS Word / Adobe PDF
  55. Savings Bonds:  Discontinuation of Program (click here for more information)
  56. Safety Glass Prescription Order Form (R 02/10):  click here (can only be accessed on the City's Intranet
  57. Safety Orientation Checklist: Adobe PDF
  58. Selective Certification Authorization, Request for (CS-64, R 11/06):  MS Word / Adobe PDF
  59. Self-Service Instructions and Information: click here
  60. Sick Leave (Medical) Certification (CBP-157, R. 1/8/13):  MS Word  /  Adobe PDF 
  61. Sick Leave, Application for (CBP-156, R 12/12), Absence Due to Personal Illness:  MS Word  /  Adobe PDF
  62. Statement of Expenses Incurred for City of Milwaukee (CBP-211, R. 10/05): MS Word
  63. Suspension Notice (CS-82, R 2/12): MS Word  /  Adobe PDF
  64. Temporary or Provisional Appointees Statement of Understanding (CS-114, R 3/07): MS Word / Adobe PDF
  65. Termination Notice (CS-80, R 2/12): MS Word / Adobe PDF
  66. 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
  67. Travel Advance, Authorization for (CBP-210, R 10/05): MS Word
  68. Tuition Benefit/Reimbursement Application Process and Guidelines (click here)
  69. 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 used 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.
  70. Underfill, Request for Approval of AND Promotion After Underfill (Rule IV, Sect. 6) (CS-107, R 8/01): MS Word / Adobe PDF
  71. Verbal Warning (CS-78, R 3/07): MS Word / Adobe PDF
  72. Waiver Form (Health/Dental): Adobe PDF
  73. Worksite Assessment Form (R 11/05): Adobe PDF
  74. Written Warning (CS-79, R 8/12): MS Word / Adobe PDF
  75. W-2 Form, Request for (C-403 r6, R 3/08): MS Word / Adobe PDF  
  76. W-4 Form (2013): Adobe PDF
  77. WT-4 Form (R 11/04) Employees Withholding Exemption Certificate /New Hire Reporting:  Adobe PDF

 

SUMMER BLOOD DRIVE
Thursday, July 18
Click here for more information.

City offices will be closed on:

  • Thursday, July 4 (Independence Day)
  • Friday, July 5 (furlough day)