Deferred Compensation Forms
Human Resources Forms
Reimbursements
Automobile Mileage Claim
Form used to report personal automobile mileage reimbursement amounts. Submit form to your department payroll clerk.
Employee Relocation Expense Assistance Reimbursement
Form is used to request relocation expenses assistance reimbursement for eligible job classes and amounts. Submit form and all receipts and approved Relocation Expense Assistance and Paid Leave Advancement Authorization and Relocation Expenses Assistance Agreement forms to your department payroll clerk for review and processing.
Leaves of Absence
Request for Leave of Absence
Form is used to request leave of absence. This form is required, completed and signed by the employee, and submitted to department payroll clerk. Application for extended leaves, both paid and unpaid, must be completed by employee, or department if employee not available. Provides tracking for FMLA purposes and authorizes continued benefit coverage when appropriate per MOU’s and Resolution.
Medical Leave Checklist for Employees
Medical Leave Request/Status Report or a signed doctor’s note is required when an employee is absent due to a medical condition. Submit these documents to your department payroll clerk.
Catastrophic Leave
Catastrophic Leave Request
Form is used to request leave due to catastrophic situation after all other paid leave balances have been depleted. Submit form, signed by Department, to Human Resources.
Catastrophic / Decedent Leave Transfer
Form is used by employees wishing to donate their paid leave time to assist another employee whose paid time has been depleted due to a catastrophic event. Submit form to ACTTC-Payroll.
Catastrophic Leave / Decedent’s Benefit Request
Form used to donate time to another employee, or beneficiary of deceased employee, that is experiencing a catastrophic leave event. Submit to ACTTC-Payroll.
Domestic Partner
Domestic Partnership Affidavit (and Termination)
Submit this form to Auditor-Payroll to have domestic partnership officially recognized by the County of Sonoma. The third page of this document is used for terminating this official status with the County.
Other
Designation / Receipt of Check Upon Death
In case of death of employee, this form determines to whom the County sends final paychecks or other benefits such as insurance, deferred compensation, and retirement benefits. Submit form to ACTTC-Payroll for employee file.
Timecard Penny Rounding Explanation
Retirement Buy Back Information Request
Employee may be eligible to purchase and receive service credit for prior county service and medical leave of absence, or to redeposit contributions previously withdrawn. Submit form to ACTTC-Payroll.
Payroll Information Request Form
Use this form to request duplicate copies of W-2 forms, research of deferred compensation catch-up eligibility, or other earnings information. Submit form to ACTTC-Payroll.
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