HR Forms and Checklists

M-O Forms

• Makeup Time Checklist
  If you are considering a makeup time policy for your employees, use this checklist before implementing the policy to make sure you are covering all the key issues.
  Preview
• Makeup Time Request
  If you have a makeup time policy, have your employees use this form to request time off and schedule makeup time.
  Preview
• Makeup Time Request - Spanish
  If you have a makeup time policy, have your employees use this form to request time off and schedule makeup time.
  Preview
• Manager's Checklist to Avoid Discrimination
  Provide this checklist to managers to help them avoid saying or doing things that could be construed as discriminatory, including interviews, performance evaluations and disciplinary actions.​​​
  Preview
• Mandatory Harassment Prevention Training Checklist
  Use this checklist when reviewing a harassment prevention course to make sure you have all of the necessary information on the course, curriculum and trainers.​​
  Preview
• Meal Break - On Duty
  When you have a nonexempt worker whose work prevents them from being able to take a meal break and both you and the worker intend for the worker to spend the 30-minute meal break while still on duty, use this form. WARNING - On-duty meal breaks are enforceable in very limited circumstances, please consult with legal counsel before using this form.​
  Preview
• Meal Break - On Duty - Spanish
  When you have a nonexempt worker whose work prevents them from being able to take a meal break and both you and the worker intend for the worker to spend the 30-minute meal break while still on duty, use this form. WARNING - On-duty meal breaks are enforceable in very limited circumstances, please consult with legal counsel before using this form.
  Preview
• Meal Break Waiver - Employee Shift 6 Hours or Less
  When you have a nonexempt worker who will work a shift of six hours or less and both you and the worker wish to waive the required 30-minute meal break, use this form.
  Preview
• Meal Break Waiver - Employee Shift 6 Hours or Less - Spanish
  When you have a nonexempt worker who will work a shift of six hours or less and both you and the worker wish to waive the required 30-minute meal break, use this form.
  Preview
• Meal Break Waiver - Second Meal
  Updated
  When you have a nonexempt worker whose shift of more than 10 hours but no more than 12 hours, the worker has not waived his first meal break, and both you and the worker wish to waive the second required 30-minute meal break, use this form.
  Preview
• Meal Break Waiver - Second Meal - Spanish
  When you have a nonexempt worker whose shift of more than 10 hours but no more than 12 hours, the worker has not waived his first meal break, and both you and the worker wish to waive the second required 30-minute meal break, use this form.
  Preview
• Medical Provider Network - Notice of Plan Modification
  Free
  Submit an original Notice of MPN Plan Modification with original signature, any necessary documentation, and a copy of the Notice and documents to the Division of Workers' Compensation.​
  Preview
• Military Service Checklist
  Use this checklist to create and implement a military service leave policy for your company.
  Preview
• Military Spouse/Registered Domestic Partner Request for Leave - 25 or More Employees
  Provide this form to employees who are requesting time off when their spouse or registered domestic partner is on leave from military deployment.
  Preview
• Minimum Wage Order
  Free
  Post this official California Minimum Wage notice next to the IWC Wage Order for your industry.
  Preview
• Minimum Wage Order - Spanish
  Free
  Post this official California Minimum Wage notice next to the IWC Wage Order for your industry.
  Preview
• Minimum Wage Order Supplement for Covered Health Care Employees
  New | Free
  Effective October 16, 2024, covered California health care employers must post this supplemental minimum wage notice alongside the General Minimum Wage Order, MW-2024.
  Preview
• Minimum Wage Order Supplement for Fast Food Restaurant Employees
  Free
  Effective April 1, 2024, California fast food restaurant employers must post this supplemental fast food minimum wage notice — showing the current minimum wage rate for fast food restaurant employees — in addition to the General Minimum Wage Order, MW-2024.
  Preview
• Minors - Statement of Intent to Employ and Request for Work Permit - Form B1-1
  Free
  Use this form when employing minors who are required to attend school and file it with the school district for each minor. You can obtain this form by contacting the Office of the Superintendent of the minor's school district. The form should be completed by the minor and signed by the employer.​​
  Preview
• Missed or Short Meal Period Acknowledgement
  Personalize

  Provide this form for employees to acknowledge they missed or had a shortened meal period on a workday. This form also requires they acknowledge that company policy requires they take an unpaid, off-duty meal period of no less than 30 minutes whenever scheduled to work for a period of more than five consecutive hours in a workday. 

  Preview
• Missed or Short Meal Period Acknowledgement — Spanish
  Personalize
  Provide this form for employees to acknowledge they missed or had a shortened meal period on a workday. This form also requires they acknowledge that company policy requires they take an unpaid, off-duty meal period of no less than 30 minutes whenever scheduled to work for a period of more than five consecutive hours in a workday.
  Preview
• Missed or Short Rest Break Acknowledgement
  Personalize

  Provide this form for employees to acknowledge they missed or had a shortened rest break on a workday. This form also requires they acknowledge that company policy requires them to take on uninterrupted 10-minute net rest period for every four hours they work (or major fraction thereof).

  Preview
• Missed or Short Rest Break Acknowledgement — Spanish
  Personalize
  Provide this form for employees to acknowledge they missed or had a shortened rest break on a workday. This form also requires they acknowledge that company policy requires them to take on uninterrupted 10-minute net rest period for every four hours they work (or major fraction thereof). 
  Preview
• New Employees Print Specifications Report - Form DE34
  Free
  If you create your own format to report new hires to the state rather than using the official DE34 form, this information sheet contains the necessary data to insure that your format complies with the state's requirements.
  Preview
• New Employees Report - Form DE34
  Free
  Federal law requires all employers to report to EDD within 20 days of start of work all employees who are newly hired or rehired. This information is used to assist state and county agencies in locating parents who are delinquent in their child support obligations. An individual is considered a new hire on the first day in which they perform services for wages. In addition, any employee who is rehired after a separation of at least sixty (60) consecutive days must also be reported within the 20 days.
  Preview
• New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Do Not Offer a Health Plan)
  Free
  Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who do not offer a health plan. ​
  Preview
• New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Do Not Offer a Health Plan) - Spanish
  Free
  Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who do not offer a health plan. ​​
  Preview
• New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Offer a Health Plan)
  Free
  Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who offer a health plan to some or all employees. ​
  Preview
• New Health Insurance Marketplace Coverage Options and Your Health Coverage (for Employers That Offer a Health Plan) - Spanish
  Free
  Under the Affordable Care Act, employers must provide a notice of coverage options to employees. The U.S. Department of Labor has provided this model notice for use by employers who offer a health plan to some or all employees.  ​
  Preview
• Notice of Employee Death
  Use this form to report an employee's death for any reason, unless you know that the employee has a surviving minor child. Send a copy of the notice to the Division of Workers' Compensation.
  Preview
• Notice of Final Decision to Withdraw Employment Offer - Criminal History Only
  Personalize
  This form can be used to conduct a criminal background check after (1) a conditional offer of employment has been made to a job applicant and (2) the Notice of Preliminary Decision to Withdraw Employment Offer and the procedures described in it have been provided. Criminal background inquiries cannot be conducted prior to a conditional job offer and a final decision to withdraw an offer of employment based in any part on criminal history cannot be made until the Preliminary Notice and procedures have been provided.
  
  Use this form to notify an applicant that you have made the final decision to withdraw their conditional job offer based, at least in part, on a criminal background check.
  
  For information on obtaining and using criminal history, see Restrictions on Obtaining Criminal History and Obtaining Background Checks and Investigations by Employers. For information on investigative consumer reports, see Obtaining Investigative Consumer Reports.
  
  This form is not intended for use if you are hiring in San Francisco, the City of Los Angeles or the unincorporated areas of Los Angeles County; these regions are covered by the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative in Hiring Ordinance and/or the Los Angeles County Fair Chance Ordinance for Employers.
  Preview
• Notice of Final Decision to Withdraw Employment Offer - Criminal History Only - Spanish
  Personalize
  This form can be used to conduct a criminal background check after (1) a conditional offer of employment has been made to a job applicant and (2) the Notice of Preliminary Decision to Withdraw Employment Offer and the procedures described in it have been provided. Criminal background inquiries cannot be conducted prior to a conditional job offer and a final decision to withdraw an offer of employment based in any part on criminal history cannot be made until the Preliminary Notice and procedures have been provided.
  
  Use this form to notify an applicant that you have made the final decision to withdraw their conditional job offer based, at least in part, on a criminal background check.
  
  For information on obtaining and using criminal history, see Restrictions on Obtaining Criminal History and Obtaining Background Checks and Investigations by Employers. For information on investigative consumer reports, see Obtaining Investigative Consumer Reports.
  
  This form is not intended for use if you are hiring in San Francisco, the City of Los Angeles or the unincorporated areas of Los Angeles County; these regions are covered by the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative in Hiring Ordinance and/or the Los Angeles County Fair Chance Ordinance for Employers.
  Preview
• Notice of Offer of Regular Modified or Alternative Work for Injuries Occurring on or After 1-1-13 (DWC-AD 10133.35)
  Free
  Use this form in making a return-to-work offer. This form is to be used for injuries occurring on or after 1/1/13.
  Preview
• Notice of Preliminary Decision to Withdraw Employment Offer - Criminal History Only
  Personalize
  This form can be used to conduct a criminal background check after a conditional offer of employment has been made to a job applicant. Criminal background inquiries cannot be conducted prior to a conditional job offer. Use this form to notify an applicant that you may withdraw their conditional job offer based, at least in part, on a criminal background check. Include a copy of the report with this notice.
  
  For information on obtaining and using criminal history, see Restrictions on Obtaining Criminal History and Obtaining Background Checks and Investigations by Employers. For information on investigative consumer reports, see Obtaining Investigative Consumer Reports.
  
  This form is not intended for use if you are hiring in San Francisco, the City of Los Angeles or the unincorporated areas of Los Angeles County; these regions are covered by the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative in Hiring Ordinance and/or the Los Angeles County Fair Chance Ordinance for Employers.
  Preview
• Notice of Preliminary Decision to Withdraw Employment Offer - Criminal History Only - Spanish
  Personalize
  This form can be used to conduct a criminal background check after a conditional offer of employment has been made to a job applicant. Criminal background inquiries cannot be conducted prior to a conditional job offer. Use this form to notify an applicant that you may withdraw their conditional job offer based, at least in part, on a criminal background check. Include a copy of the report with this notice.
  
  For information on obtaining and using criminal history, see Restrictions on Obtaining Criminal History and Obtaining Background Checks and Investigations by Employers. For information on investigative consumer reports, see Obtaining Investigative Consumer Reports.
  
  This form is not intended for use if you are hiring in San Francisco, the City of Los Angeles or the unincorporated areas of Los Angeles County; these regions are covered by the San Francisco Fair Chance Ordinance, the Los Angeles Fair Chance Initiative in Hiring Ordinance and/or the Los Angeles County Fair Chance Ordinance for Employers.
  Preview
• Notice to Employee as to Change in Relationship
  Personalize
  Use this form to notify an employee of a change in the employment relationship, such as a layoff or termination.
  Preview
• Notice to Employee as to Change in Relationship - Spanish
  Personalize
  Use this form to notify an employee of a change in the employment relationship, such as a layoff or termination.
  
  Preview
• Notice to Employee: Government Inspection of Employment Eligibility Records
  Free
  ​If you receive a Notice of Inspection from a federal immigration enforcement agency, such as Immigration and Custom Enforcement (ICE), you must provide notice to all employees by posting this Notice to Employee (Labor Code section 90.2) in your workplace within 72 hours of receiving the Notice of Inspection. You must also post a copy of the Notice of Inspection along with this form and provide a copy of the Notice of Inspection to an employee upon reasonable request.​
  
  In addition, you are required to: (1) post this notice in any language you normally use to communicate employment-related information to the employee; and (2) provide a copy of this notice to the employees’ exclusive collective bargaining representative(s), if any.​
  
  Preview
• Notice to Employee: Government Inspection of Employment Eligibility Records - Spanish
  Free
  ​If you receive a Notice of Inspection from a federal immigration enforcement agency, such as Immigration and Custom Enforcement (ICE), you must provide notice to all employees by posting this Notice to Employee (Labor Code section 90.2) in your workplace within 72 hours of receiving the Notice of Inspection. You must also post a copy of the Notice of Inspection along with this form and provide a copy of the Notice of Inspection to an employee upon reasonable request.
  
  In addition, you are required to: (1) post this notice in any language you normally use to communicate employment-related information to the employee; and (2) provide a copy of this notice to the employees’ exclusive collective bargaining representative(s), if any.​
  
  Preview
• Office and Commercial Establishment Safety Including Ergonomics and Office Chemical Safety
  General office and commercial establishment safety is not regulated by Cal/OSHA standards. However, the Injury and Illness Prevention Standard requires employers to identify and prevent any hazards that may be present. Use this data sheet to identify and address office hazards.​
  Preview
• Optional Worksheet to Help You Fill Out the Annual Summary - Form 300A
  Free
  Use this worksheet to gather the data needed to prepare the Summary of Work-related Injuries and Illnesses (Form 300A).
  Preview
• OSHA Log 300 - Guidelines for Determining Recordability
  These guidelines help you determine whether you need to record a work-related injury or illness on Log 300 forms.
  Preview
• Overtime Calculation Worksheet
  Use this form to calculate overtime for your nonexempt employees.
  Preview
• Overtime Request
  Provide these forms to supervisors, managers and employees and train all employees in the use of this form whenever overtime work is needed or performed.​
  Preview
• Overtime Request - Spanish
  Provide this form to supervisors, managers and employees and train all employees in the use of this form whenever overtime work is needed or performed.
  Preview