The Personnel Advisor - Human Resource Advisory Services

Illinois Personnel Advisor—Forms

Note: Only forms noted as "Printable" may be downloaded and printed. All other forms will be made available upon your paid subscription.

ACCIDENT INVESTIGATION REPORT—Document the cause and action taken as the result of an accident

AFFIRMATIVE ACTION PLAN MODEL—Document Affirmative Action analysis

AMERICANS WITH DISABILITIES—Reasonable accommodation forms (members only)

APPLICATION FOR EMPLOYMENT—Prospective job applicants
ATTENDANCE LOG—Track employee attendance for an entire year. Record vacation, sick days, family leave and other absences.
BACKGROUND CHECK AUTHORIZATION FORM

CERTIFICATION OF FITNESS FOR DUTY—Fitness for duty certification by health care provider regarding employee's ability to return to work.
CHECKLIST FOR BARRIERS FOR DISABLED WORKERS—Assess the workplace to accommodate persons with disabilities

CHECKLIST FOR NEW EMPLOYEES—Orientation of new employees

COBRA MODEL FORMS—Model "General" Notice and "Election" Notice of COBRA Continuation Coverage Rights (members only)

EMPLOYEE DEVELOPMENT PLAN—Develop plans to increase skills and knowledge for employers and employees
EMPLOYEE HANDBOOK—Employers can use the employee handbook template to create or revise a company employee policy handbook. (members only)
EMPLOYMENT DECISION TABLE—Decision making during the hiring selection process

EMPLOYMENT INTERVIEW EVALUATION—Evaluate an applicant during an interview

EXEMPT JOB DESCRIPTION—Write exempt job descriptions

EXIT INTERVIEW—Obtain information from an employee about the job, management and the organization
DIRECT DEPOSIT AUTHORIZATION FORM—Optional form for payroll direct deposit authorization and bank information

FAMILY MEDICAL LEAVE ACT—FMLA Forms (members only) (Revised January 2009):

—Medical Certificate Forms (two forms that may be used to obtain medical certificate from healthcare provider):

▪ For Employee's Serious Health Condition (Form WH-380E)

▪ For Family Member's Serious Health Condition (Form WH-380F)

—Notice of Eligibility and Rights & Responsibilities (WH-381) (may be used to respond to employee's request for leave)

—Designation Notice (WH-382) (to approve or deny employee’s request for leave)

—Military Leave Certification (two forms that may be used to obtain certification for FMLA military leave):

▪ Certification of Qualifying Exigency for Military Family Leave (WH-384)

▪ Certification of Serious Injury or Illness of Covered Service Member (WH-385)

—Employee Request for FMLA Leave Form (sample form employees may use when requesting family leave)

INCIDENT RESOLUTION FORM—Document resolutions to workplace incidents

I-9 FORM—EMPLOYMENT ELIGIBILITY VERIFICATION FORM—[Rev.08/07/09]

INTERNET AND COMPUTER USAGE POLICY—Company policy for employee's use of company automation, including all forms of Internet/Intranet access

IRS FORM W-4 (2010)—Employee IRS Withholding Allowance Certificate

LEAVE OF ABSENCE REQUEST FORM—Sample form employees may use when requesting leave
NAME/ADDRESS CHANGE FORM—Record and document employee name or address changes

NEW EMPLOYEE INFORMATION FORM—Emergency and general contact information for the employee

NEW HIRE REPORTING FORM—Illinois Department of Employment Security (IDES)—New Hire Reporting Form

NON-EXEMPT JOB DESCRIPTION—Write non-exempt job descriptions

ONE-ON-ONE MEETING GUIDE—Organize and document one-on-one meetings

OSHA—Employer Records of Occupational Injuries and Illnesses—The following links provide the required occupational injury and illness forms and instructions under the Occupational Safety and Health Administration (OSHA)

Summaries and totals of workplace injuries and illnesses must be posted between February 1 and April 30 of each year.

OSHA Form 300—Log of Work-Related Injuries and Illnesses

OSHA Form 300A—Summary of Work-Related Injuries and Illnesses

OSHA Form 301—Injury and Illness Incident Report

OSHA Complete Forms Package—12 pages including instructions

Exempt employers (those not subject to record keeping requirements)

OUTLINE FOR JOB OFFER LETTER—Send to an applicant to make a job offer

PERFORMANCE PLAN AND EVALUATION—Evaluate individual workers or teams of workers

SAFETY DEPARTMENT MEETING—Document department safety and health meetings

SAFETY INSPECTION CHECKLIST—Assess the safety of the workplace

STAFFING PLAN GUIDE—Develop a staffing or hiring plan

TERMINATION CHECKLIST—Assist the employer when planning to terminate an employee
TIME SHEET—Weekly time sheet record of employee work hours

WAGE AND SALARY PLAN—Develop salary plans

WH 380—"Certification of Health Care Provider" (Form WH 380) is an optional form for employers to obtain certification from a healthcare provider that a serious health condition exists and qualifies for leave under the Family and Medical Leave Act (FMLA).

WORKLOAD ACTIVITY LOG—Assess workloads in order to determine staff needs

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