Forms

• MS Word or MS Excel:
  - Right click on the link and choose "Save Target As". 
  - When the "Save As" window appears, go to the folder you want to save it to and click "Save".
• PDF: The free Adobe Reader allows you to view, complete and print PDF files.

2012 Health and Dental Insurance Enrollment

Absence from the City Request (MS Word) (Print 2 copies)

Administrative Support Team Timesheet (PDF)

Alternative and Flexible Work Schedules Request (PDF) - (see APM 2-35 (PDF))

Architectural Services Request Form (MS Word)

Authorization for Expenditure (MS Word) (see APM 1-6 (PDF))

Authorization to Hire Above Step 1 - Non-Represented Employees (MS Word)

Beneficiary Designation Instructions and Form (PDF) - CHANGE of Beneficiary Form (from Wisconsin Department of Employee Trust Funds)

Billing Authorization (PDF) - Also available as a Word template (BillAuth.dot)

Common Council and Board and Commission Meeting Dates, Submission, Preparation and Coordination of Ordinances, Resolutions and Reports to the Common Council: (see APM 3-1 (PDF))

• Registration Statement (PDF)
• Registration Statement (MS Word)

Car Data Sheets:

• Personally Assigned Vehicles (MS Word)
• Police Personally Assigned Vehicles (MS Word)
• CARS Monitor (MS Word)

C.D.L. Daily Inspection Sheet (PDF)

Certification Hiring Request (MS Word)

• Job Family Under-Representation Chart (Annual Placement Goals) (PDF)
• Job Family Descriptions (PDF)
• Applicant Status Code - Not Selected List (PDF)
• Hiring Examination/Interview Panels and Hiring-Red Flag Procedures (PDF)

Classification Change Worksheet (MS Word)

Committee Attendance Record (MS Excel)

Contract for Purchase of Services (MS Word)

Contract for Purchase of Services (Architect) (MS Word)

Contract for Purchase of Services (Roadway Design Engineering) (MS Word)

Contract for Purchase of Services (Design Professionals) (MS Word)

Contract for Purchase of Services (Public Health - Madison & Dane County) (MS Word)

Contract Request Form - Office of City Attorney (MS Word)

Dane County Printing and Services:

• Business Card Order Form (PDF)
• Fast Copy Requisition (PDF)
• Production Printing Requisition (PDF)

Deferred Compensation:

• ICMA-RC
• Lincoln
• 457 Emergency Withdrawal Packet (PDF)

Direct Deposit Authorization Agreement (PDF)

Direct Deposit Termination (PDF)

Document Services Request

Early Release of Paychecks (MS Word)

Effective Business Practice (PDF)

Emergency Contact Form (PDF)

Employee Change of Address and/or Telephone Number (MS Word) (see APM 2-37 (PDF))

Employee Evaluation Reports:

• Employee Probation Report (MS Word): Initial / Final

• Employee Trial Period Evaluation Report (MS Word): Initial / Final

• Employee Evaluation Report (MS Word): Initial / Final

Employee Self-Identification Form (PDF)

Employment Application for Promotion or Transfer (PDF)

Employment Screening Authorization Form (PDF) - (see APM 2-25 (PDF))

Family/Medical Leave: (see APM 2-21 (PDF))

• Application (PDF)
• Health Care Provider Certification (Employee - Serious Health Condition) (PDF)
• Health Care Provider Certification (Family Member - Serious Health Condition) (PDF)
• Provider Certification - Birth, Adoption or Foster Care (PDF)
• City of Madison Family and Medical Leave Policy (PDF)
• Family and Medical Leave Act of 1993 (PDF)
• Wisconsin Family and Medical Leave Law (PDF)
• Procedure for the Administration of Family and Medical Leaves of Absence (PDF)
• Military Family Leave: Certification of Qualifying Exigency (PDF)
• Military Family Leave: Certification for Serious Injury/Illness of Covered Service Member (PDF)

Family Partner Designation Form (PDF) (see APM 2-14 (PDF))

Flexible Spending Account

Grievance Procedure for Non-Represented Employees Form (PDF) - (see APM 2-16 (PDF))

I-9 Package (PDF)

Incident Report (MS Word)

Incident Report - Vehicle Accident (MS Word) - (see APM 5-2 (PDF))

Leave Adjustments (PDF) - Also available as a Word template (LeaveAdj.dot)

Leave of Absence Without Pay (see APM 2-31 (PDF))

• Application for Leave of Absence Without Pay or Medical/Disability Leave Without Pay (MS Word)

Legistar:

• Creation of a City Committee Template (MS Word)
• "Notice of Additional Public Meetings" Template (MS Word)

LPO Form (MS Excel) - LPO Form Instructions (Excel)

• LPO Instructions (PDF) - Conditions of Purchase (PDF) - Authorization Form (MS Word)

Mileage Log:

• January 1, 2010: Personal Auto Use (MS Excel)
• January 1, 2011: Personal Auto Use (MS Excel)
• July 1, 2011: Personal Auto Use (MS Excel) (No changes as of January 1, 2012)
• Workers' Compensation (MS Excel) / Workers' Compensation (PDF)

Notary Bond Application(MS Word)

Oath of Office (PDF 28KB)

Open Records Law (PDF) - Also available as a Word template (OpenRec.dot)

Past Due P-Card Statement (MS Word)

Payroll Authorization Signature List (MS Word)

P-Card Agreement (MS Word) - P-Card Application (MS Word) - P-Card Problem Purchases (MS Word)

Personnel Action (PDF) - Also available as a Word template (Action.dot)

Policies and Procedures For Internal and External Training: (see APM 2-10 (PDF))

• Absence from the City Request (MS Word) (Print 2 copies)
• Training Request (Internal)
• Individual Development Plan (MS Word)

Position Description Instructions

• Position Description (MS Word)
• Supervisory Analysis Form (MS Word) - Also available as a Word template (SupvForm.dot)

Pre-Pay & Supplemental Check Request (PDF) - Also available as a Word template (Prepay.dot)

Prohibited Harassment and/or Discrimination Policy: (see APM 3-5 (PDF))

• Complaint Register (Attachment 1) (MS Word)
• Notice of Investigation - Respondent (Attachment 2) (MS Word)
• Complaint Process Flowchart (PDF) 

Public Works Contract Administration

Request for Amendment to the Madison General Ordinance (MS Word)

Request for Transfer of Funds (PDF)

Request to City Attorney (MS Word)

Request to Fill Vacancy (MS Word)

Self-Declaration of Disability Form (PDF)

Sole Source Justification Form (MS Word)

Statement of Interests Form (MS Word)

Surplus Auction Information Form (MS Word)

Take Our Daughters and Sons To Work Day

Tax Exempt Form S-211 (PDF)

Telecommuting Agreement (PDF) - (see APM 2-34 (PDF))

Telephones (see APM 3-12 (PDF))

• Cellular Telephone Qualifiers (PDF)
• Cellular Telephone Usage Rules (PDF)
• Requirements for Employee-Provided Cellular Telephones (PDF)
• Monthly Cell Phone Reimbursement Approval Form (MS Word)

Timesheet (MS Excel)

Training Evaluation (PDF)

Training Request (Internal)

Travel Guide (Pocket) (PDF)

Trip Settlement:

• January 1, 2010 (MS Excel)
• January 1, 2011 (MS Excel)
• July 1, 2011 (MS Excel)

Vacation Selection Process: Instruction(PDF) / Form (MS Word) (For Use by Police Department)

W-4 Employee's Withholding Allowance Certificate (Federal) (PDF)

W-4 Employee's Withholding Allowance Certificate (State of Wisconsin) (PDF) (Print page 1 ONLY)

Wage Insurance Premiums Form (MS Word) (For Use by Payroll Clerks)

Workers' Compensation:

• Accident Report
  • Employee (PDF)
  • Supervisor (PDF)
  • Time Loss Worksheet (MS Excel)

• Workers' Compensation Information (PDF)

• Mileage Log: MS Excel / PDF  

• Medical Status Report (PDF) - Pick up this form from your supervisor, Payroll Clerk or the Finance Department.

• WKC-12-E (MS Word)