New To State Service: Represented
As part of the hiring process, you will need to read and sign a number of documents. Please review the documents listed below for newly hired represented employees new to state service.
- Print the appropriate pages of the documents and bring them with you on your first day of work.
- If you do not have access to a printer, take time to familiarize yourself with the documents and you can print them when you arrive on your first day.
- During your first week of employment, you will meet with a Personnel Specialist who will receive the documents and answer any outstanding questions.
New to State Employee Appointment Documents
Print and Sign
Employee Action Request (STD 686)
Print page 1 of this two-page document.
Request for Nondisclosure of Employee Home Address (STD 677)
Print page 1 of this one-page document.
CalSTRS Employee Emergency Contact Information (AD-1894)
Print page 1 of this one-page document.
State Employee Race/Ethnicity Questionnaire (CalHR 1070)
Print page 1 of this one-page document.
Military Service Information (CalHR-190)
Print page 1 of this one-page document.
Authorization to Use Privately Owned Vehicles on State Business (STD 261)
Print page 1 of this one-page document.
Employment Eligibility Verification (Form I-9)
Print all pages of this four-page document.
Member Reciprocal Self-Certification Form (PERS-EAMD-801)
Print page 3 of this five-page document.
Designation of Person(s) Authorized to Receive Warrants (STD 243)
Print page 1 of this one-page document.
Prior Exempt Service Questionnaire (CalHR-004)
Print page 1 of this two-page document.
Oath of Allegiance and Declaration of Permission to Work for Persons Employed by the State of California (STD 689)
Print page 1 of this one-page document.
CalSTRS Policies and Acknowledgement Documents
Print and Sign
CalSTRS Confidentiality, Non-Disclosure and Acceptable Use Agreement (ISO 1949)
Print page 1 of this two-page document.
CalSTRS Internet Usage Acknowledgment
Print page 1 of this one-page document.
Incompatible Activities Agreement (AD-150)
Print pages 1 and 2 of this two-page document.
For Your Reference
CalSTRS Employee Relationship Policy
CalSTRS Zero Tolerance for Workplace Violence Prevention Policy
CalSTRS Physical Security & Emergency Management
Internet Usage Policy
New to State Employee Benefits Information and Applicable Enrollment Forms
Print and Sign
Health Benefits Plan Enrollment for Active Employees (HBD-12)
Print pages 1 and 2 of this three-page document.
Dental Plan Enrollment Authorization (STD 692)
Print page 1 of this two-page document.
Premier Vision Plan Enrollment Authorization (CalHR 774)
Print page 1 of this two-page document.
Dependent Eligibility Verification Checklist
For Your Reference
CalPERS Health Program Guide
CalPERS Health Benefit Summary
Vision Care Plan Disclosure Statement and Evidence of Coverage
Flex Elect Program Handbook
Savings Plus Program 401K/457 Plan Highlights
New Employee’s Guide to Workers’ Compensation
State of California’s Employee Assistance Program
Disability Insurance Provisions
Paid Family Leave Benefits
