Forms | CSUSB

Miscellaneous Payroll Forms

Form	Description
Employee Action Request (EAR) - std. 686	Form to complete withholdings, address, and name changes. A wet signature is needed please print, complete form and return to HR in Sierra Hall 110.
Additional Concurrent Employment Form	Form to initiate a request to the employee's department head and supervisor requesting that the employee teach a course.
Worksheet to Calculate OT for NonExempt Who Teach	Worksheet to calculate the appropriate overtime rate for non-exempt staff who are approved to teach a course as lecturer.
Direct Deposit	Direct deposit authorization form to request payments to be automatically deposited into a designated bank account.
Procedure to Request a Duplicate W-2 Wage & Tax Statement Form	Link to the State Controller's Office Fill and Print Duplicate W-2 Wage & Tax Statement Form PDF and Duplicate W-2 information.
Understanding Your Paycheck	Form to explain each section of the pay warrant and direct deposit advice
Payroll Deficit Hours Reconciliation Form	Form used to reconcile deficit hours with vacation, CTO, or personal holiday.
How To Use The Work Number	The Work Number user instructions for the online and phone employment and wage verification service.
The Work Number Worksheet	The Work Number worksheet should be completed by employee and given to verifier.
Sample Employee Data Report Request Form	Form used to request a copy of the information potentially given to those requesting employment information from The Work Number.

Form	Description
Hourly Time Certification Form	Absence and Additional Time Worked Report
Hourly Time Certification Instructions	Instructions for hourly employee reported time and pay certification
Timesheet (STD 634)	Absence and Additional Time Worked Report
CSUSB Personnel/Payroll System Authorization Process	Step by step guide for Personnel/Payroll System Authorization
Payroll Signature Authorization Form	Form used to identify department designees to collect paychecks and direct deposit advices, sign timesheets and student listings, etc.
Master Payroll Certification Authorization Form	Form used to identify the Attendance Clerk for Master Payroll Warrant Authorization process.

Form	Description
Monthly Attendance Summary Form (AM 634)	Form is used to report absences taken, but not reported within 90 days of the current period and to correct/adjust absences for a finalized period.
Notice of Work Schedule Change Form	Form is used to change employee work schedules to a 'Personal Schedule' that is not available in the Absence Management 'Predefined Schedule' list.