Forms and Information

Employee Forms & Information

Leave Forms

Family Medical Leave Policy & Forms

The information on this web page will help you navigate Family/Medical Leave as it is applied at the City and Borough of Juneau. Family/Medical Leave is administered in accordance with the federal Family Medical Leave Act, the National Defense Authorization Act for FY2008, the Alaska Family Leave Act, and CBJ Administrative Policy 13-01, Family/Medical Leave.

Whether you are an employee who may need to request leave or a manager or supervisor who has an employee with a Family/Medical Leave entitlement, the following information will provide you with information and guidance needed to administer Family/Medical Leave. If you have questions about specific applications or issues after you have reviewed the materials, please contact the Human Resources/Risk Managment Office.

Health Benefits / Life insurance Forms

Safety Program Forms

New Employee Forms

  • HRRM News & Information
    • IAFF (International Association of Fire Fighters)
      • Bargaining Agreement New
      • Letters of Agreement
        • 08-I-01 Fire Mechanic Salary and Pay Scale
        • 08-I-02 BLS EMT-1
        • 12-I-03 SOG Update 50.8 Scheduled Leave
        • 12 I-02 Pay Schedule
        • 13-1-01 Seasonal Firefighter-EMT I Employees
        • 13-1-04 Change to Healthy Reward Contribution FY14
        • 15-1-15 Acting Captain, Health Insurance Contributions, Bargaining Unit Seniority & Updated SOC.
      • IAFF Pay Schedules
      • Website: www.iaff4303.org
    • MEBA (Marine Engineers Beneficial Association)
      • ¬†Bargaining Agreement New 11/22/16
      • Letters of Agreement
        • Letter Adopting Sept. 2006 Personnel Rule Revisions
        • 09-M-01 Reclassification of Bldg Custodians
        • 14-M-01 Hourly employees acting in salaried positions
      • MEBA Pay Schedules
      • Website: www.d1meba.org
    • PSEA (Public Safety Employees Association)
      • Bargaining Agreement New – effective 7/1/16
      • Chart on Applicability of Personnel Rules, Also see Appendix B of Bargaining Agreement
      • PSEA Pay Schedules
      • Letters of Agreement
        • 08-P-01 Academy Pay
        • 08-P-03 Officers entering/returning from Academy
        • 08-P-04 Overtime While Not Attending Academy
        • 08-P-05 Shift Differential Pay
        • 09-O-01 Establishment of Paid Reserve Officers
        • 10-P-01 Part-time Employee
        • 12-P-01 On Call Dispatch Positions
        • 12-P-02 Pay Schedule, Overtime Defined Master Pay Differential Pay and Employer and Employee Contributions
        • 12-P-05 Sworn Officers Asssigned to Downtown Walking Beat Patrol
        • 14-P-02 Compensation for working a Grant/Billable Detail
        • 15-P-01 Sworn Officers Overtime Threshold and FLSA Period
        • 15-P-02 Association Dues or Services Fee for Paid Reserve Officers and On-Call Dispatchers.
        • 15-P-03 Canine Handlers
        • 15-P-04 Uniforms
  • CBJ Policies and Procedures
  • Employee Assistance Program
  • Employee Benefits

Job Classifications

  • JobTitles/Pay Ranges
    • All CBJ, Listed By Class Code

Pay Information

  • Pay Dates
  • Salary Schedules
  • Payroll Forms
  • Pay Calculator

Employee Self Service Instructions

  • ESS & Time Entry (Hourly)
  • ESS & Time Entry (Salary)

Pay-Related Forms & Information

  • Payroll Withholding, W4 Form and Instructions
  • Direct Deposit Enrollment Form
  • Application for New or Replacement Social Security Card
  • Mileage Reimbursement – See CBJ Personnel Rule 18 PR 045
    • Reimbursement Form
  • Deferred Comp Change Form
  • Personal Leave Cash-In Request.

Employee Self Service Instructions

  • ESS & Time Entry (Hourly)
  • ESS & Time Entry (Salary)

Manager Self Service Instructions

  • Time Card Approval
  • Pay Day & Time Sheet Schedules
    • 2016 Employee Pay Schedule
    • 2016 Admin Pay Schedule with black-out dates
    • 2017 Employee Pay Schedule
  • Time Sheet Sample Form
    • Hourly & Salary Pay Tables
      • MEBA Employees
        • 2012
        • 2013
        • 2014
        • 2015
        • 2016
      • Unrepresented Employees
        • 2012
        • 2013
        • 2014
        • 2015
        • 2016
      • PSEA Employees
        • Fiscal Year 2017
      • IAFF Employees
        • 40Hour/Week
          • 2013
          • 2014
          • 2015
        • 56Hour/Week
          • 2013
          • 2014
          • 2015
      • Eaglecrest Employees
        • FY15
        • Payroll Calculator
  • Job Classification
    • Job Class Titles/Pay Ranges

Risk Management Forms & Information

Safety-Related Forms

  • Site Review Form
  • Safety Meeting/Training Form

Accident/Injury Forms

  • Print Copy Accident Injury Report Revised 2016
  • Fillable Accident Injury Report Revised 2016
  • Print Copy Property Damage Report Revised 2016
  • Fillable Property Damage Report Revised 2016
  • Instructions for completing the Report of Occupational Injury Form
  • 07-6100 Employee Report of Occupational Injury Form
  • 07-6101 Employer Report of Occupational Injury Form

Updated 4/1/16

Health Insurance

  • Medical, Dental, Vision Claim forms
  • ¬†Prescription Claim forms
  • Affidavit of Marriage
  • Air Travel Benefit Advisory
  • Student Verification
  • Enrollment/Change form

Life Insurance

  • Voluntary Life-ADD enrollment
  • Change of Beneficiary form
  • Fiscal Year 2015 Risk Management Report
  • Notice of Claim Form

More contents will be added to this site later. To request the addition of human resource or risk management forms or information, contact Anna Percival in the Human Resources & Risk Management Department at 586-5250 or Anna.Percival@juneau.org