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Payroll Services Forms

Form

Description

Campus

Damage Payments

   

Damage Payment Report of Services Performed Before Signing Loyalty Oath (PDF)

Payment made to an employee who performs services for the university prior to signing the State Oath of Allegiance. A damage payment constitutes a settlement of an employee's claim based upon services rendered. UC Davis

Loyalty Oath—Damage Payment Release (PDF)

Payment made to an employee who performs services for the university prior to signing the State Oath of Allegiance. A damage payment constitutes a settlement of an employee's claim based upon services rendered. UC Davis

Special Handling of Payroll

   
Declaration of Lost or Destroyed UCD Check (PDF) Used by employees to request a stop payment and reissue of check that has been lost, destroyed, or was not received with check date prior to October 1, 2019. UC Davis
Declaration of Lost or Destroyed UCD Payroll Vendor Check (PDF) Used by vendor to request a stop payment and reissue of check that has been lost, destroyed, or was not received with check date prior to October 1, 2019. UC Davis

UPAY 564-3 - One-Time Payroll Payment Authorization (PDF)

Used by department to document approval of transactions expected to occur once, not routinely or expected to occur again. UC Davis
UPAY 644D - Payroll Time Reporting Adjustment Worksheet (XLS) May be used by department to document approval for adjustments to payroll earnings. UC Davis

Transfer of Payroll

   
Dept Pre-Approval Form: Transfer of Salary Expense (Extramural Fund Source)  (PDF) Form submitted by department with Contracts & Grants Accounting approval to move expenses onto account with 120 day restrictions. UC Davis

Salary Expense Transfer Access Application (PDF)

Application form completed by department and submitted to Kuali (FIS) Help Desk for approval to perform SET transactions in KFS, and/or access reports 339 and 340 in FIS DS, for expenses on ledger prior to October 1, 2019. UC Davis

Interlocation Payment Forms

   
UPAY 560-T - Temporary Interlocation Transfer or Multilocation Appointment (PDF) Used by either Host or Home campus for employee with payroll payment coming from more than one campus, ongoing or continuing payments expected. UC Davis
UPAY 644C-T - Interlocation One-Time Payment (PDF) Used by either Host or Home campus for employee with payroll payment coming from more than one campus, one payment expected, not ongoing. UC Davis

Employment Forms

   

Statement of Citizenship (PDF)

Form completed by non-US citizens at time of hire to identify tax status as resident or non-resident alien. UC Davis
Verification of Previous Employment (PDF)

Used by employee to request verification of previous UC, CSU, or State of CA employment.
Submit to: Central Payroll Office

UC Davis
W-4 (Non-Resident Alien) - Employee's Federal-State Withholding Allowance Certificate (PDF) Used by non-resident alien employee to have employer deduct the correct amount of tax withholding from wages. UC Davis / UC Davis Health