Pay-4-Performance

Pay-4-Performance Webpage and Training Schedule

(Personnel Rule Chapter 3 - PR-304)  [PDF]

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

CHAPTER VIII (Grievance And Disciplinary Procedures) & Forms 

Workplace Posters (required by the Federal & State government) For more information on workplace posters please contact Human Resources.

Paulina Paz, Employee Relations Analyst I
Phone: 928-373-1175
Fax: 928-373-1078 
e-mail: Paulina.Paz@yumacountyaz.gov

Colonial Supplemental Insurance
2 Forms

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

Employee Assistance Program (EAP)
Provided by Support Linc

Employee Leave Sharing Program (ELSP)
1 Document & 2 Forms

Employee Tuition Reimbursement Program
1 Document & 1 Form

CHAPTER IV (BENEFITS) PR-419  (Word Doc)

Tuition Reimbursement Rule Form  [PDF]

Family Medical Leave (FMLA)
Document & Forms

View: Yuma County FMLA Webpage

Flexible Spending Account (FSA)
Documents & Forms

View: FSA Webpage

SSA Mexico Network (YCEBT PPO)
2 Forms

View: SSA Webpage

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

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) (contact Human Resources)
Public Safety Retirement (PSPRS) (online forms)
Elected Official Retirement (EORP) (online forms)

Federal Tax Forms
1 Form

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

YCEBT Additional Benefit Information & Forms

Wellness Program

Age Related Physical Exam Acknowledgement
1 Form

 Wellness Health Fair

Physical Attestation Form  [PDF]

Vendor Application Form [PDF]

Relocation Policy
1 Document & 1 Form

CHAPTER II (EMPLOYMENT) PR-209   [PDF]

Relocation Form  [PDF]

Request for Verification or Public Records

Please visit the County Administrator
Reports, Permits and Forms' Webpage

1 Document & 1 Form

Request for Public Records Policy  [PDF]

Request for Public Records Form  [PDF]

Review Personnel File - 1 Form

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

We would appreciate you taking the time to fill out this form, and return it to the Human Resources 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]

Safety Excellence Award Program
Attention to safety is important, please feel free to nominate any county employee for this award.

1 Document & 1 Form

Safety Excellence Award Information Flyer  [PDF]

Safety Excellence Award: Award Nomination Form  {Word Doc}

Safety Forms

7 Forms

• New Employee Safety Orientation

• Safety Inspection Form

• Incident Report Form

• Safety Training Request Form

• SafePersonnel on-line training form

• Ergonomics Assessment Request Form

• Fire Drill & Evacuation Form