Forms
Non-Benefit Forms
General
Cell Phone Reimbursement Form
Fitness Reimb Request: CPOA
Fitness Reimb Request: IAFF, CBC & PSM
Info Systems Setup Form
​Key Request Form
Outside Employment
Personnel Transaction
Recruitment Request Form
L39 Safety Footwear Reimb Form
Sick Leave Payout Form (IAFF)
SEIU Certification Pay Request Form
SEIU Tool Allowance Form
Leave of Absence
California Family Rights Act (CFRA) Fact Sheet
FMLA Fact Sheet
Leave Request Form (LOA-1)
Physician Certification of a Serious Health Condition (LOA-2)
Payroll & Scheduling
PAYROLL
2023 Payroll Calendar
2023 Form W-4
2023 Form DE-4 (CA)
Direct Deposit
Change of Address/Name/Phone
Looking for ICMA or Sterling Salary Redirection Forms? Visit the
Employee Benefits Page.
SCHEDULING
Flexible Schedule Request
Voluntary Furlough Program Policy (FY 20-21)
Voluntary Furlough Program Application
Risk Management
ADA Complaint Form
Report of Accident, Theft, Damage or Loss Involving City Property (PDF)
Report of Accident, Theft, Damage or Loss Involving City Property (Word)
Ride Along Waiver
Volunteer/Intern Application
Unpaid Volunteer/Intern Application
Workers’ Compensation
City of Chico Physician Letter
Claim Form DWC-1
Incident Report
Physician Pre-Designation Form
Workers' Compensation Flow Chart