Reduction in Force

(University Submissions Only)

Please enter the employee's working d

Date Employee was notified of RIF

Please indicate the amount the agency is requesting to pay. If requesting Severance enter the Severance amount. If requesting DSR enter the DSR amount.

Please indicate whether the agency is requesting to pay RIF Severance or DSR

Please indicate whether the employee worked full time or part-time.

Has the RIF candidate achieved Career Status

Enter the number of hours per week the employee worked

Enter the Job Code for the RIF Candidate's position

Enter the Job Classification for the employee's position.

Enter the Salary Grade or Band Level for

Enter the Employee's annual salary at the time of the RIF

Please enter the applicant's work address

Please indicate the County the employee worked in.

Please attach the following documents for OSHRs review: RIF Severance request form This two page document should be saved as a pdf file. RIF Plan and Checklist- The RIF Pland and OSHR RIF Checklist should be saved as one .pdf file DSR Letter - If the employee is eligible for DSR you must attach the DSR letter from the retirement center. this document can be saved as part of the Severance/DSR file. Your request will be returned if the employee is eligible but letter is not attached.