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D-F Forms

  • Day of Rest - Acknowledgement and Waiver
    Personalize
    Provide this form for employees to acknowledge and waive their right to one “day of rest” in each seven-day workweek. Employers cannot take any action to encourage employees to waive their right to a day of rest. However, an employer can allow an employee to choose not to take a day of rest, as long as the employee is fully informed of their right.
  • Day of Rest - Acknowledgement and Waiver - Spanish
    Provide this form for employees to acknowledge and waive their right to one “day of rest” in each seven-day workweek. Employers cannot take any action to encourage employees to waive their right to a day of rest. However, an employer can allow an employee to choose not to take a day of rest, as long as the employee is fully informed of their right.
  • DE4 - California Employee's Withholding Certificate
    Free
    Copy and distribute this form from the EDD to employees so they can determine their withholding allowances.
  • Deceased Employee Compensation Collection Form
    Provide this form to the surviving spouse, registered domestic partner, guardian or a conservator of an estate (Affiant) in order to allow collection of the decedent's salary or other compensation.​
  • Defining Harassment Quiz
    Use this quiz as a training tool during sexual harassment training for employees.​
  • Direct Deposit Authorization
    Give this form to an employee who requests his pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.
  • Direct Deposit Authorization - Spanish
    Give this form to an employee who requests his pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.
  • Disclosure and Authorization to Obtain Consumer Credit Report – California

    ​In California, credit reports can only be used for employment purposes in specific limited circumstances. If allowed, use this form to provide disclosures required by California law and to obtain written authorization from an individual before obtaining a credit report for employment purposes. Provide this form along with the Disclosure and Authorization to Obtain Consumer Credit Report – Federal. Download and read the Instructions prior to using this disclosure and authorization.

    Instructions​​​​​
  • Disclosure and Authorization to Obtain Consumer Credit Report – California – Instructions
    Download and read these Instructions prior to using Disclosure and Authorization to Obtain Consumer Credit Report – California.​​​​
  • Disclosure and Authorization to Obtain Consumer Credit Report – Federal
    Use this form to provide disclosures required by federal law and to obtain written authorization from an individual before obtaining a credit report for employment purposes. For applicants located in California, provide this form along with the Disclosure and Authorization to Obtain Consumer Credit Report – California.
  • Disclosure and Authorization to Obtain Investigative Consumer Report – California
    Use this form to provide disclosures required by California law and to obtain written authorization from an individual before obtaining an investigative consumer report for employment purposes. Provide this form along with the Disclosure and Authorization to Obtain Consumer Credit Report – Federal.

    Employers subject to the San Francisco Fair Chance Ordinance must also provide a city-specific notice of rights before conducting a criminal background check.
  • Disclosure and Authorization to Obtain Investigative Consumer Report – Federal
    Use this form to provide disclosures required by federal law and to obtain written authorization from an individual before obtaining an investigative consumer report for employment purposes. For applicants located in California, provide this form along with the Disclosure and Authorization to Obtain Consumer Credit Report – California.

    Employers subject to the San Francisco Fair Chance Ordinance must also provide a city-specific notice of rights before conducting a criminal background check.
  • Diversity, Equity and Inclusion Policy
    A diversity, equity and inclusion policy can demonstrate your commitment to fostering a diverse workforce, providing the opportunity for advancement for all individuals and ensuring equity in the workplace for all employees.
    This policy goes above and beyond the required Harassment, Discrimination and Retaliation Prevention policy by not simply complying with the law that prohibits discrimination or harassment against employees on the basis of race, gender, sexual orientation or any other protected characteristics; it communicates to your employees that such differences are celebrated and viewed as assets to your Company.
  • Diversity, Equity and Inclusion Policy - Spanish
    A diversity, equity and inclusion policy can demonstrate your commitment to fostering a diverse workforce, providing the opportunity for advancement for all individuals and ensuring equity in the workplace for all employees.
    This policy goes above and beyond the required Harassment, Discrimination and Retaliation Prevention policy by not simply complying with the law that prohibits discrimination or harassment against employees on the basis of race, gender, sexual orientation or any other protected characteristics; it communicates to your employees that such differences are celebrated and viewed as assets to your Company.
  • Doctors First Report of Occupational Injury or Illness
    After an injured employee's first doctor's visit, the doctor completes this report and sends two copies to the employer's workers' compensation insurance carrier or the self-insured employer within five days of the initial examination. Failure to file a timely doctor's report may result in assessment of a civil penalty.​​
  • Earned Income Tax Credit — Consent to Receive Electronic Notices
    Personalize
    Provide this form for employees to consent to electronically receive the Earned Income Tax Credit notice as well as other notices, statements or materials required under Revenue and Taxation Code Section 19853(a)(1).
  • Earned Income Tax Credit - Employer Required Notification
    Provide this form to employees along with their W-2 or 1099 to notify them of their rights under the federal and California Earned Income Tax Credit (EITC) program.
  • Earned Income Tax Credit - Employer Required Notification - Spanish
    Provide this Spanish​ form to employees along with their W-2 or 1099 to notify them of their rights under the federal and California Earned Income Tax Credit (EITC) program.
  • EEO and Pay Data Reporting Requirements
    Review this chart to help determine if you are required to collect and provide gender, racial and ethnic workforce data, also known as EEO reporting, to the California Civil Rights Department and the federal Equal Employment Opportunity Commission.
  • Emergency Action Plan
    Personalize
    Use this form to set up an Emergency Action Plan (EAP) for the workplace. The EAP includes which employees are in charge in case of an emergency and emergency contact phone numbers.
  • Employee Disciplinary Warning
    Use this form to record a disciplinary warning issued to an employee and the employee's acknowledgment of the warning.
  • Employee Disciplinary Warning - Spanish
    Use this form to record a disciplinary warning issued to an employee and the employee's acknowledgment of the warning.
  • Employee Letter - PDL Only
    Use this letter to respond to notice of an employee’s absence due to Pregnancy Disability Leave (PDL). Respond within 10 calendar days of the request or no later than the following payday, whichever is sooner. Use this letter if you are under 50 employees and not covered by the federal Family and Medical Leave Act (FMLA) or if the employee seeking leave is not eligible for FMLA leave.
  • Employee Letter - PDL Only - Spanish
    Use this letter to respond to notice of an employee’s absence due to Pregnancy Disability Leave (PDL). Respond within 10 calendar days of the request or no later than the following payday, whichever is sooner. Use this letter if you are under 50 employees and not covered by the federal Family and Medical Leave Act (FMLA) or if the employee seeking leave is not eligible for FMLA leave.
  • Employee Orientation Checklist
    Personalize
    Have an employee complete this form as you go through the orientation process, ensuring that you cover all necessary topics and distribute all required forms. ​
  • Employer Proof of Identity and Disbursement of Final Pay - Deceased Employee
    Complete this form upon receipt of the Deceased Employee Compensation Collection Form. Place a copy of this completed form in the Decedent's file and provide a copy to the Affiant.​​​​
  • Employers Report of Occupational Injury or Illness
    Use this form to report an employee's injury or illness if it requires more than first aid. Send a copy to your insurer, or if self-insured, to the Department of Industrial Relations within five days following notice of injury or illness.
  • Employing Minors Checklist
    Use this checklist to ensure compliance when employing minors.
  • Employment Application - Long Form
    Personalize
    Use this form for new applicants. The long form includes space for more detailed information and employment history, and all other necessary sections. Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer. California also prohibits employers from asking job applicants about their prior salary history. Download and read the Instructions prior to using this employment application form.
  • Employment Application - Long Form - Instructions
    Download and read these Instructions prior to using Employment Application - Long Form and Employment Application - Long Form - Spanish​.​​​
  • Employment Application - Long Form - Spanish
    Personalize
    Use this form for new applicants. The long form includes space for more detailed information and employment history, and all other necessary sections. Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer. California also prohibits employers from asking job applicants about their prior salary history. Download and read the Instructions prior to using this employment application form.
  • Employment Application - Short Form
    Personalize
    Use this form for new applicants. The short form requires less employment history information.​ Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer. California also prohibits employers from asking job applicants about their prior salary history. Download and read the Instructions prior to using this employment application form.
    Instructions​​​​
  • Employment Application - Short Form - Instructions
    Download and read these instructions prior to using Employment Application - Short Form and Employment Application - Short Form - Spanish​.​​
  • Employment Application - Short Form - Spanish
    Personalize
    Use this form for new applicants. The short form requires less employment history information.​ Remember that California prohibits employers from seeking criminal history information prior to a conditional job offer. California also prohibits employers from asking job applicants about their prior salary history.​​ Download and read the Instructions prior to using this employment application form.
    Instructions​​​​
  • Employment Interview Checklist
    Use this sample checklist to ensure that your interview process is the same for all applicants and does not expose you to lawsuits.
  • Employment Offer Letter
    Personalize
    Use this letter to convey information to a new employee about whom they will report to, job title, starting date and time, rate of pay and classification. This letter is simply for an employee’s information and is not to be used or construed as a contract of employment.
  • Employment Offer Letter - Spanish
    Use this letter to convey information to a new employee about whom they will report to, job title, starting date and time, rate of pay and classification. This letter is simply for an employee’s information and is not to be used or construed as a contract of employment.
  • Employment Offer Letter (Temporary Employee)
    Use this sample letter to detail a job position to a temporary employee, stating the period of time for which he or she has been hired, the procedure should employment status change and the benefits that are not available to temporary employees. The letter does not serve as a contract of employment.​​
  • Exempt Analysis Worksheet - Administrative Exemption
    Use this worksheet to help evaluate the exempt or nonexempt status for your administrative employees.
  • Exempt Analysis Worksheet — Computer Professional Exemption
    Use this worksheet to help evaluate the exempt or nonexempt status for your computer professionals.​​
  • Exempt Analysis Worksheet - Executive/Managerial Exemption
    Use this worksheet to help evaluate the exempt or nonexempt status for your managers or executives.​
  • Exempt Analysis Worksheet - Professional Exemption
    Use this worksheet to help evaluate the exempt or nonexempt status for your professional employees (such as teachers, doctors or attorneys).​
  • Exempt Analysis Worksheet - Salesperson Exemption
    Use this worksheet to help evaluate the exempt or nonexempt status for your sales staff.
  • Exit Interview
    Personalize
    Use this form to gather an employee's comments at termination regarding his or her employment with your company. Completion of the exit interview by an employee is entirely voluntary.
  • Fair Credit Reporting Act - Summary of Your Rights
    Free
    Provide a copy of this summary to the consumer (employee or applicant) before taking adverse action based on the results of a credit report. A copy of the report must accompany the summary.​​
  • Fair Credit Reporting Act - Summary of Your Rights - Spanish
    Free
    ​Provide a copy of this summary to the consumer (employee or applicant) before taking adverse action based on the results of a credit report. A copy of the report must accompany the summary.​​
  • Family Care and Medical Leave and Pregnancy Disability Leave Notice
    Free
    This notice must be posted and must also be given to an employee who is seeking pregnancy disability leave or reasonable accommodation/transfer for pregnancy, childbirth or related medical condition and/or who is seeking family care or medical leave. This notice applies to California employers with five or more employees (subject to the California Family Rights Act (CFRA) or Family and Medical Leave Act (FMLA)). You must post this notice in a place commonly used by employees, such as a break room. Employers are also encouraged to give this notice at time of hire to each new employee. This notice is also part of the California and Federal Employment Notices Poster available at the CalChamber Store.​​
  • Family Care and Medical Leave and Pregnancy Disability Leave Notice - Spanish
    Free
    This notice must be posted and must also be given to an employee who is seeking pregnancy disability leave or reasonable accommodation/transfer for pregnancy, childbirth or related medical condition and/or who is seeking family care or medical leave. This notice applies to California employers with five or more employees (subject to the California Family Rights Act (CFRA) or Family and Medical Leave Act (FMLA)). You must post this notice in a place commonly used by employees, such as a break room. Employers are also encouraged to give this notice at time of hire to each new employee. This notice is also part of the California and Federal Employment Notices Poster available at the CalChamber Store.
  • Features of Mass Layoff and Plant Closing Laws
    Review this chart any time you are considering a layoff of a large number of employees or the temporary or permanent close or relocation of a facility or department. This chart identifies covered employers, notification requirements, penalites, trigger events, exceptions and notice content.​
  • Federal Family and Medical Leave Act Poster
    This poster satisfies the required federal posting notice regarding the availability of family and medical leave.

    Employers should give a copy of this FMLA notice at the time of hire if they do not publish an employee handbook​. Best practice is to provide the notice at time of hire regardless of whether you also include the notice in your employee handbook.​​​​​
  • Federal Family and Medical Leave Act Poster - Spanish
    This poster satisfies the required federal posting notice regarding the availability family and medical leave.

    Employers should give a copy of the FMLA notice at the time of hire if they do not publish an employee handbook. Best practice is to provide the notice at time of hire regardless of whether you also include the notice in your employee handbook.
  • Final Paycheck Acknowledgment
    Use this form to have an employee certify receipt of final paycheck.
  • Final Paycheck Acknowledgment - Spanish
    Use this form to have an employee certify receipt of final paycheck. Employers not fluent in Spanish should refer to the English version to complete this form properly.
  • Final Paycheck Direct Deposit Authorization
     Give this form to an employee who requests his final pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.
  • Final Paycheck Direct Deposit Authorization - Spanish
    Give this form to an employee who requests his final pay delivered by direct deposit to one or more bank accounts. Before distribution, indicate the maximum number of direct deposit accounts and financial institutions.
  • Final Paycheck Worksheet
    Personalize
    Use this form to calculate the amount of an employee’s final paycheck. It is illegal for an employer to withhold a final paycheck and failure to pay all wages due may result in penalties.
  • Fire Prevention Checklist
    Use this checklist to collect information related to fire prevention and to make sure you are taking proper measures to prevent fires in the workplace. This includes auditing those measures to ensure that they are being followed. This information should be integrated into your Fire Prevention Plan.  ​
  • Fire Prevention Plan
    Personalize
    Use this form to set up a Fire Prevention Plan (FPP) for the workplace. The FPP inlcudes which employees are in charge in case of a fire and emergency contact phone numbers for local fire departments. 
  • FMLA - Notice of Eligibility and Rights and Responsibilities
    Personalize
    Use this form to notify employees taking a family and medical leave only regarding their eligibility for leave and any associated righ​ts and responsibilities.​
  • FMLA - Notice of Eligibility and Rights and Responsibilities - Spanish
    Personalize
    Use this form to notify employees taking a family and medical leave only regarding their eligibility for leave and any associated righ​ts and responsibilities.​
  • FMLA Designation Notice
    Personalize
    Use this form to designate leave as FMLA only, to provide conditional approval of the request for leave if more information is necessary or to deny the request.
  • FMLA Designation Notice - Spanish
    Personalize
    Use this form to designate leave as FMLA only, to provide conditional approval of the request for leave if more information is necessary or to deny the request.
  • FMLA PDL Designation Notice
    Personalize
    Use this form to notify an employee if their leave for PDL/FMLA is approved, conditionally approved or denied.
  • FMLA PDL Designation Notice - Spanish
    Personalize
    Use this form to notify an employee if their leave for PDL/FMLA is approved, conditionally approved or denied.
  • FMLA Sample Policy — 50 or More Employees
    Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to Family and Medical Leave Act (FMLA) leave.
  • FMLA Sample Policy — 50 or More Employees — Spanish
    Use this sample to create your policy that communicates any employee requirements and gives notice to your employee of their right to Family and Medical Leave Act (FMLA) leave.
  • FMLA/CFRA Documentation Checklist - For Employer Use Only
    Use this checklist to assist you in complying with all regulations regarding family and medical leave and California Family Rights Act (CFRA) leave. ​​​