Official Web Site of the City of Duluth, Minnesota USA • www.DuluthMN.gov

Change Text Size
A | A

home » EMPLOYMENT » FORMS »

Human Resources Division : Forms

Job Action Form

Job Action Form (Non-Bargaining Unit Positions)

Employee Data Maintenance Form

Veterans' Preference Application

ClearScript Web Access

2010 Formulary PDF

Coverage Determination/Redetermination REQ.

Prescription Claim Form

Prescription Mail Order Form

BlueCross BlueShield Claim Form

Employee Incident Report of Inappropriate
Behavior Form.doc

Return to City of Duluth Human Resources Page

Return to the City of Duluth Main Page

Policy & Procedure Forms

Acknowledgment of Understanding

ADA Qualification Determination Worksheet

Adverse Action Notification

Charitable Contributions

Chemical Test Form

Chemical Testing Facility Info

Departing Employee Checklist

Employee Chemical Test Request

Employee Data Maintenance Form

Employee Recognition Nomination Form

Employer Information Form

Employer Job Offer

Exit Information Form

Exit Interview Questionnaire

Family Leave Notification

FAVR Plan Information

FAVR Plan Enrollment Form

FAVR Plan Driver Checklist

FAVR Plan Status Form

FAVR Plan Monthly Mileage Form

First Report of Injury

First Report of Injury Checklist

Fitness for Duty Appointment Notification

Injury Reporting Guide & Checklist

Intermittent Employment-Employee Status Determination

Interview Results

Job Action Form

Job Action Form
(Non-Bargaining Unit Positions)

Letter of Concern

Minnesota Workers Comp Info Sheet

Motor Vehicle Record Request

Notice of Job Assignment

Notice of Removal While on Probation

Notice of Test Results

Notice to Employee Requesting Leave

Organizational Orientation Checklist

Organizational Orientation Quality Survey

Paid Leave Request

Parking Permit Request

Pre-Adverse Action Notification

Physician Certification

Physician's Report/Employee Work Status

Report of Discrimination, Harassment, or Violence

Request for Unpaid Family Leave

Request for Unpaid Leave of Absence

Sick Leave Request Memo

Special Use Request Form

Summary of Rights

Temporary Employee Performance Report

Temporary Employment Application

Temporary Job Title List

Temporary Position Expiration

Temporary Termination Memo

Use of Temps governed by PELRA and Civil Service Code

Vacation Donation Form

Vacation Donation Recipient Request

Vehicle Accident Report Form

Vehicle Safety Checklist

Vehicle Travel Data Form

Voluntary Leave Request Form

Work Injury Lost Time

Worksite Orientation Checklist

Worksite Orientation Quality Survey

©2012 City of Duluth, Minnesota. All Rights Reserved. Disclaimer | Contact Us