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SUPERVISORY FORMS

Pay-4-Performance

Pay-4-Performance Page and Training Schedule

(Personnel Rule Chapter 3 - PR-304)

Personnel Action Form (PAF)
1 Form

PAF [Word Doc]
PAF [PDF]

New Hire - Employee Eligibility Verification I-9 Form - please see Human Resources

Recruitment & Selection Process

Requisition for Open Position
2 Forms [Word Doc]

County Request Form

Courts Request Form

Reallocation of position or Reclassification of position [PDF]
Please see YUMA County Rules & Regulations or contact Human Resources

Vacancy Review is a comprehensive term that permits Human Resources to assess and discuss the need to fill employment vacancies (promotions, transfers, and new hires) that are compensated from the General Fund or other County funding source. The Vacancy Review does not apply to certified public safety personnel.
1 Document & 1 Form

Vacancy Review Memo [PDF]

Vacancy Review Policy [PDF]

Voluntary Grade Decrease Request
1 Form
Voluntary Grade Decrease Request Form [Word Doc]

Workplace Posters (required by the Federal & State government) 

For more information on workplace posters please contact Human Resources.

Jessica Rodriguez, Employee Relations Analyst
Phone: 928-373-1163
Fax: 928-373-1078 
e-mail: Jessica.Rodriguez@yumacountyaz.gov

EMPLOYEE FORMS (used by all employees)

Colonial Supplemental Insurance
2 Forms

Claim Form and Instructions [PDF]
Request for Service Authorization Form [PDF]

Employee Assistance Program (EAP)

Provided by Support Linc - visit website for EAP Health Care Services
 Phone: 1 (888) 881-5462 or call Benefits for assistance at (928) 373-1165

Employee Extended Illness Bank (EIB)
1 Document & 2 Forms

EIB Rule Document (CHAPTER IV (BENEFITS) PR-417) [PDF]
Donation Form [PDF]
Application Form [PDF]

Employee Tuition Reimbursement Program
1 Document & 1 Form

Tuition Reimbursement Rule Document and Form [PDF]
(CHAPTER IV (BENEFITS) PR-419)

Family Medical Leave (FMLA)
Document & Forms

Yuma County FMLA Page

Flexible Spending Account (FSA) Documents & Forms

View: FSA page

SSA Mexico Network (YCEBT PPO)
2 Forms

View: SSA Page

PERSONAL INFORMATION FORMS

Change of Address or Name 

1 Document & 2 Forms

Name Change Procedure [PDF] 

Name Change Forms: Please call Human Resources 928-373-1013

(See Name Change Procedure for other required forms)

Address Change Form [PDF] (please notify your Retirement System)

Direct Deposit - 1 Form

Direct Deposit Form [PDF]

Retirement (Change in Address, Name, Beneficiary. etc.)
5 Forms

Arizona State Retirement Forms (ASRS) (online forms)
Correction Retirement (CORP) (online forms)
Court Corrections Officer Retirement (ACORP) (Please call Human Resources (928) 373-1013
Public Safety Retirement (PSRS) (online forms)
Elected Official Retirement (EORS) (online forms)

Federal Tax Forms
1 Form

(Required for any change in name, status, dependents, etc.)
Federal Tax Form - W4 {PDF]

Arizona State Tax Form
1 Form
State Tax Form - A4 [PDF]

YCEBT Additional Benefit Information & Forms

View: Benefits page or contact Benefits at (928) 373-1165

OTHER FORMS

Wellness Program

Age Related Physical

Exam Acknowledgement Form

Physical attestation form [PDF]

Relocation Policy
1 Document & 1 Form

Relocation Form

(CHAPTER II (EMPLOYMENT) PR-209)

Request for Verification or Public Records

Please visit the County Administrator 'Reports, Permits and Forms' page
Request Form

Or contact Human Resources at 928-373-1113

Review Personnel File - 1 Form

Request Form [PDF]

Separation Information - 1 Form

Exit Interview Form [PDF]

GRIEVANCE/DISCIPLINARY ACTION FORMS - CHAPTER VIII [PDF]

Grievance Forms [PDF]
Flow Chart [PDF]
Disciplinary Forms [PDF]
Flow Chart [PDF]

 

Exit Interview: Employees terminating employment with Yuma County, please see your immediate Supervisor or contact Human Resources - your Opinion counts.

 

Dear Former County Employee: We would appreciate your taking time to fill out this form, and return it to our office. If you specifically authorize, Yuma County would like permission to use the data to compile statistics.

Exit Interview - 1 Form

Exit Interview form  [PDF]

Contact Information

Yuma County Human Resources Department
Phone:
(928) 373-1013
Fax: (928) 373-1153
Office Hours: Monday - Friday, 8:00 a.m. to 5:00 p.m. 
Location: 198 S. Main St., Yuma AZ 85364

Call (928) 373-1113 with questions and comments or e-mail Debra.Hancock@yumacountyaz.gov

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