FORMS

Assignment Area Map. To be used as reference with PC Form 5005 - Request for Transfer (Change of work location) and PC Form 5004.
Classified Employee Leave Package - PC 5006
Classified Employment Processing Documentation Reference Sheet - PC PROCREF - Reference guide for appropriate documentation
Classified Retired Employee's Acknowledgment Form - PC 5301
Classified Staff Resignation Form - PC 5209
Classified Unauthorized Absence Worksheet - PC 5096 Form to be submitted by a department when a classified employee is absent without authorization.
Day-to-Day Substitute Assignment Record - PC 5311 Form to be used by substitute employees in maintaining a personal record of day-to-day assignments.
Employee File Request Form - PC 8102
Employee/Contractor Exit Checklist - PC 110 -To be used in determining if employee/contractor has returned all district property prior to leaving the District.
Examination Appeal - PC 81 - Form to be completed to submit an examination appeal.
Freeze Exemption Form
Information, Instructions and Conditions of Employment for Classified Substitutes - PC 5312 Contains the conditions of employment for classified substitutes.
Nepotism Certification Form - PC 5109 -Form is used for District employees and applicants in disclosing any relationship, which is covered by PC Rule 720prior to appointment to a position.
Non-Routine Payment Request Form Salary Payment for $5,000 and Above PC FORM 9074
Non-Routine Payment Request Form Salary Payment for Under $5,000 PC FORM 9074
Notice of Outstanding Work Performance - PC 8254 -This form is to be filled out to provide an official record of commendation for a classified employee for outstanding work performance.
Position Information Form - LAUSD/HR Form 9990 -This form is to request a reclassification between certain pre-approved classes.
Request for A Salary Step Placement - PC 5115 Request for A Salary Step Placement Beyond the First Step in The Salary Range
Request for Bilingual Differential - PC 6421 Request for Bilingual Differential or Selective Certification for Bilingual Skills
Request for Change of Assignment - PC 5004 Request for change of classified assignment (shift, basis, time, status, and classification). This is not a request for transfer form.
Request for Differential in the Office of the Superintendent PC Form 9075
Request for Multiple Assignments - PC From 5108 This form can be used to request multiple assignments for an employee who is currently working in another classification.
Request for Personnel Action (RPA) - LAUSD/PC 9073 Request for Personnel Action is used to establish, change, and to close classified positions.
Request for Reclassification by Director Approval (RDA) - PC 5104 - PC 80.6 Send Form to Personnel Commission After Administrative Approval.
Request for Reinstatement - PC 5126 Classified employees submit this form to request reinstatement to the classified service.
Request for Restoration or Transfer of Name - PC 5189b This is the request to restore a name to the Classified eligibility list, if in good standing.
Request for Transfer -PC 5005 Request for transfer form is to be submitted by an employee when requesting a transfer or a change of work location. Use the assignment area map as reference.
Request to Modify Entrance Qualifications - PC 8104
Statement of Availability for Employment - PC 5404 A classified employee will complete the Statement of Availability to record their shift and location preferences.
Statement Regarding Confidentiality (Rodda Act) - PC 38
Substitute Unsatisfactory Report PC 5310
Temporary Application Form - PC 6003 Application for temporary work.