UCLA Payroll Services

A guide for departments to use when adding or changing employee records on the Employee Data Base (EDB).


The chart below lists forms that must accompany various types of EDB Entry/Update transactions. Some forms must be sent to an Office of Record due to the requirements of regulatory agencies even though the data they contain is entered directly into the EDB by the department (e.g., citizenship and tax forms). Other forms (e.g., parking deductions forms) must be sent to a central campus office which is responsible for updating the EDB.

Form Name Form No. Office of Record
Academic Affirmative Action Selection & Compliance   Academic Personnel Office
Academic Sabbatical/Leave of Absence   Academic Personnel Office
Benefits Enrollment/Opt Out Form UPAY 850 HR - Benefits
Certificate of Foreign Status for Federal Tax Withholding UC W-8BEN Campus Payroll
• Staff Employee Requisition
• UCLA Staff Employment Offer Verification Notice
• Employee's Resume, Employment Application, or Staff Transfer Application
(for non-academic career appointments in non-clerical positions)

Employment Eligibility Verification I-9 Campus Payroll
Job Description (for non-academic career appointments)   HR-Compensation
Life and AD&D - Designation of Beneficiary UPAY 718 HR - Benefits
***Out of State Withholding Form UPAY 830 Campus Payroll
***• Parking Services Payroll Deductions Authorization 1615LA Campus Parking
***• Parking Services Payroll Deductions Cancellation 1615CLA Campus Parking
State Oath of Allegiance and Patent Agreement UPAY 585 Campus Payroll
Statement Concerning Your Employment in a University Position Not Covered by Social Security UCRS 419 UC HR/Benefits - Records Management
Tax Treaty Statement (Plus applicable attachments, refer to Sec B)    Campus Payroll
• UCLA Interview and Hire Record - Career Staff Employees
• UCLA Quarterly Training Record (Both Forms - 3 year retention)
Form A
Form E
Department (Career appointments)
Unemployment Insurance Termination Report U5602 CHR - Unemployment Coordinator
University of California Pretax Transportation Deduction or Cancellation or Re-Enrollment UPAY 884 Campus Parking
Withholding Allowance Certificate W-4 Department
Work-Study Referral Form UPAY 759-4 Department (Work Study Hires)
UCRP - Designation of Beneficiary UBEN 114 UCOP
++ UCLA Medical Enterprise Competency Validation Checklist   Department
++ New Employee Hospital Orientation Confirmation of Attendance   Department
++ UCLA Medical Enterprise Department Specific Orientation   Department
++ UCLA Medical Center Job Description   Department
++ UCLA Medical Enterprise Equipment Competency Validation   Department
++ Confidentiality of Patient and Employee Information   Department

Many of the required forms are available (or can be ordered) on the web from one of the following sources:

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