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MCSC Forms

This page lists and describes Civil Service forms available for printing or downloading. To find a form, select the form from in one of the drop-down lists below grouped by type. Use the Helpful tips and instructions for downloading in Microsoft Office 2003 format (with macros to add sections/pages to the form), or PDF format (with fill-in fields to enter text), or the Civil Service Forms FAQ page .

To enable all the form features, select the "Enable Macros" button (or "Enable Content" button in MS Word 2010) when you open the templates (also see FAQs or Disabled Macros Error). 

Documents edited in PDF format cannot be saved or e-mailed electronically unless you have a software license with Adobe Acrobat. If you do not have a license, you must either mail the documents to the address provided on the documents, or fax them to the fax number indicated on the documents. 

 
 
 

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Send them to the Civil Service Internet Team.
Revised: July, 2014



 
Form Name and Number Microsoft Office 2003 Format

PDF Format

App to Continue Insurances CS-1820
This Form is for Employee Benefits, Human Resource Offices, and Retirement Use Only
 
Revised 3/2014 
CS1820 
CS1820.pdf 
Application for Leave to Appeal to the Employment Relations Board CS-1743
Revised 1/2011

CS1743 

CS1743.pdf 
Application for Persons with Disabilities and Request for Reasonable Accommodation in the Written Examination Process CS-944
Revised 5/2011
CS944 CS944.pdf
Application for the Twelve-Month Trial Appointment Program for Handicappers CS-630
Revised 7/2009
CS630 CS630.pdf
Beneficiary Designation Change CS-1781
Revised 5/2010
CS1781 CS1781.pdf
Benefit Enrollment Application CS-1777
Revised 5/2011
CS1777 CS1777.pdf
Brief in Response to Application for Leave to Appeal to the Employment Relations Board CS-1754
Revised 2/2011
CS1754 
CS1754.pdf 
Civil Service Position Description CS-214
Instructions for CS-214.doc 
Instructions for CS-214.pdf 
Revised 11/2013
CS214 CS214.pdf
Claim of Appeal as of Right to the Employment Relations Board CS-1756
Revised 2/2011
CS1756 CS1756.pdf
Dependent Care Flexible Spending Account Mid-Year Enrollment CS-1774
Revised 4/2010
CS1774 CS1774.pdf
Disability Accommodation Request by Employee CS-1668
Revised 6/2009
CS1668 CS1668.pdf
Disclosure of Interest CS-1783
Revised 4/2007
CS1783 CS1783.pdf
DMO Leave Application CS-1838
This Form is for Disability Management Office Use Only
 
Revised 12/2013 
CS1838 
CS1838.pdf 
Final Compensation Beneficiary Affidavit CS-140a
Revised 8/2007
CS140a CS140a.pdf
Final Compensation Beneficiary Designation CS-140
Revised 8/2007
CS140 CS140.pdf
Flexible Spending Accounts Life Event/Election Change CS-1784
Revised 10/2010
CS1784 CS1784.pdf
FMLA Certification Employee Relative CS-1807
New 1/2009

CS1807 

CS1807.pdf 
FMLA_Leave of Absence Request_Response CS-1810
Revised 11/2013
CS1810 CS1810.pdf
Grievance Form CS-100
Revised 4/2011
CS100 CS100.pdf
Group Appeal Contact Information (CS-1793)
Revised 1/2011
 
CS1793 CS1793.pdf
Health Care Flexible Spending Account Mid-Year Enrollment CS-1773
Revised 4/2010
CS1773 CS1773.pdf
Health Care Flexible Spending Account Continuation of Coverage CS-1814
Revised 3/2012
CS1814 CS1814.pdf
HIPAA Disclosure Authorization CS-1786
Revised 5/2004
CS1786 CS1786.pdf
HIPAA Privacy Complaint Form CS-1782
Revised 4/2011
CS1782 CS1782.pdf
Life Insurance and Accidental Duty Death Enrollment and Beneficiary Form CS-1717
This Form is for Judicial State Employees Use Only
 
Revised 11/2007
CS1717 CS1717.pdf
Non-FMLA Medical Certification by Physician CS-1835
New 2/2012 
CS1835  CS1835.pdf 
OEAI Application and Affidavit CS-1833
Revised 8/2013
CS1833 CS1833.pdf
Petition for Election CS-1760
Revised 4/2011
CS1760 CS1760.pdf
Proof of Service to Other Parties to the Employment Relations Board CS-1740
Revised 4/2011
CS1740 CS1740.pdf
QTFB Enrollment CS-1776
Revised 9/2013
CS1776 CS1776.pdf
QTFB Reimbursement Claim CS-1779
Revised 12/2013
CS1779 CS1779.pdf
Request to Order Witnesses to Appear or Produce Documents CS-1747
Revised 10/2012
CS1747 
CS1747.pdf 
Technical Appointment Complaint CS-212d
Revised 1/2008
CS212d CS212d.pdf
Technical Appointment Complaint Proof of Service to Appointing Authority CS-1759
To be used for Technical Appointment Complaints Only
 
Revised 8/2007 
CS1759 
CS1759.pdf 
Technical Classification Complaint CS-212a
Revised 1/2008
CS212a CS212a.pdf
Technical Disbursement Complaints CS-212c
Revised 1/2008
CS212c CS212c.pdf
Technical Qualification Complaint CS-212b
Revised 5/2014
CS212b CS212b.pdf
Unclassified Position Description CS-133
Revised 7/2013
CS133 CS133.pdf
Verification of Eligibility CS-1830
Revised 7/2014
CS1830 CS1830.pdf
Vets Preference Registration Form CS-1791
Revised 2/2011
CS1791 CS1791.pdf
 
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FORMS FOR MANAGERS & PERSONNEL STAFF 
Click here to e-mail any of the following forms as an attachment 
Note: Form must be saved to your computer prior to e-mailing as an attachment.
Form Name and Number Microsoft Office 2003 Format

PDF Format

Agency Candidate Credential Review Certifications CS-1753
Revised 9/2013 
CS1753 CS1753.pdf
Agency Training Coordinators Security Agreement CS-1748
Revised 8/2007
CS1748 CS1748.pdf
Appointing Authority's Comments on Technical Appointment Complaint CS-1812
Revised 11/2013
CS1812 CS1812.pdf
Appointing Authority's Comments on Technical Classification Complaint CS-1627
Revised 11/2013
CS1627 CS1627.pdf

Assistant Attorney General Performance Management and Competency Rating Form CS-1762
Attorney General Competency Model.doc 
Attorney General Compentency Model.pdf 
Revised 8/2009

CS1762 CS1762.pdf
Civil Service Position Description CS-214
Instructions for CS-214.doc 
Instructions for CS-214.pdf 
Revised 11/2013 
CS214 CS214.pdf
Discriminatory Harassment Work Rule
Revised 8/2007
Harrass Harrass.pdf
Employee Departure Report CS-301
Revised 11/2013
CS301 CS301.pdf
Employee Personal Data CS-1785
This Form is for Human Resource Offices Use Only
 
Revised 7/2010
CS1785 CS1785.pdf
Employment History File Correction Request CS-1705
Revised 7/2009
CS1705 CS1705.pdf
Evaluation of Disability Accommodation CS-1670
Revised 8/2007
CS1670 CS1670.pdf
Family Medical Leave of Absence Form CS-1787
This Form is for Employee Benefits and Human Resource Offices Use Only
 
Revised 9/2011 
CS1787 
CS1787.pdf 

Group Four and Senior Executive Service Performance Management and Competency Rating Form CS-1719
Competency and Rating Scales for Group 4 and Senior Executive Service.doc 
Competency and Rating Scales for Group 4 and Senior Executive Service.pdf
 
Revised 10/2010

CS1719 CS1719.pdf
Group One Employees Performance Management and Competency Evaluation Form CS-1750
Group One Behaviorally Anchored Rating Scales.doc 
Group One Behaviorally Anchored Rating Scales.pdf 
Revised 10/2010
CS1750 CS1750.pdf

Group Three Managers Performance Management and Competency Rating Form CS-1761
Group Three Managers Competency Rating Scales.doc 
Group Three Managers Competency Ratings Scales.pdf 
Revised 10/2010

CS1761 CS1761.pdf
Group Three Supervisors Performance Management and Competency Rating Form CS-1752
Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.doc 
Group Three Supervisor Competencies Behaviorally Anchored Rating Scales.pdf 
Revised 10/2010
CS1752 CS1752.pdf
Group Two Employees Performance Management and Competency Evaluation Form CS-1751
Group Two Behaviorally Anchored Rating Scales.doc 
Group Two Behaviorally Anchored Rating Scales. pdf 
Revised 10/2010
CS1751 CS1751.pdf
Identification of Priority Programs CS-1796
New 7/2007
CS1796 CS1796.pdf
Information Technology Position Evaluation Worksheet CS-1763
Revised 7/2009
CS1763 CS1763.pdf
Information Technology Programmer/Analyst Trainee Program Appointment Agreement CS-1755
Revised 7/2009
CS1755 CS1755.pdf
Interim Employee Rating CS-375
Revised 7/2009
CS375 CS375.pdf
Oath of Office CS-314
Revised 8/2007
CS314 CS314.pdf
Plan C Leave of Absence Form CS-1788
This Form is for Employee Benefits and Human Resource Offices Use Only
 
Revised 9/2011 
CS1788 
CS1788.pdf 
Position Bench Strength Assessment CS-1803
New 7/2007
CS1803 CS1803.pdf
Position Impact Risk Assessment CS-1798
New 7/2007
CS1798 CS1798.pdf
Position Impact Risk Assessment Description CS-1799
New 7/2007
CS1799 CS1799.pdf
Position Recoding Worksheet CS-1758
Instructions for CS-1758.doc 
Instructions for CS-1758.pdf 
Revised 7/2009
CS1758 CS1758.pdf
Position Request CS-1795
Revised 9/2008
CS1795 CS1795.pdf
Position Risk Assessment Attrition Factor CS-1800
New 7/2007
CS1800 CS1800.pdf
Position Success Profile CS-1801
New 7/2007
CS1801 CS1801.pdf
Position Success Profile-Group 2 CS-1802
New 7/2007
CS1802 CS1802.pdf
Priority Programs and Human Capital Alignment CS-1797
New 7/2007
CS1797 CS1797.pdf
Request for Credential Review CS-153
Credential Review Procedures.pdf 
Prescreen Procedures.pdf 
Revised 7/2009
CS153 CS153.pdf
Request for Employment List Extension CS-1500
Revised 7/2009
CS1500 CS1500.pdf
Request for Prior Employment History CS-1704
Revised 1/2012
CS1704 CS1704.pdf
Response to Disability Accommodation Request CS-1669
Revised 8/2007
CS1669 CS1669.pdf
Senior Executive Management Assistant Service (SEMAS) Limited-Term Employment Agreement CS-1738
Revised 7/2013
CS1738 CS1738.pdf
Senior Executive Service Limited-Term Employment Agreement CS-1720
Revised 7/2013
CS1720 CS1720.pdf

State Police Performance Management and Competency Rating Form CS-1792
Competency and Rating Scales for State Police Troopers and Sergeants.doc 
Competency and Rating Scales for State Police Troopers and Sergeants.pdf
 
Revised 8/2009

CS1792 CS1792.pdf
Survey on the Quality of the Agency Candidate Pool CS-1745b
Revised 7/2009
CS1745b CS1745b.pdf
Survey on the Quality of the Civil Service Applicant Pool CS-1745a
Revised 7/2009
CS1745a CS1745a.pdf
Training Programs Nominations - Billing CS-457
Revised 8/2007
CS457 CS457.pdf
Unclassified Position Description CS-133
Revised 7/2013
CS133 CS133.pdf
Vacancy Posting Security Agreement CS-1765
Revised 7/2009
CS1765 CS1765.pdf
Work Rule for Workplace Safety
Revised 8/2007
Safety Safety.pdf
Working Out of Class CS-1804
Revised 8/2009
CS1804 CS1804.pdf
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Helpful Tips:
  • If you do not have Microsoft Office 97 or later version (e.g., Office 2000, XP), use the pdf version of the form.
  • Read the instructions before you fill out the application. The instructions contain valuable information on filling out the application.
  • Review the quality of printing of your form and do not submit a form where printing is incomplete, not formatted properly, or otherwise looks odd.
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How to Download and Use Civil Service Forms 

If you decide to "Open the file from its current location," do not be alarmed if a "Warning" dialog box pops up indicating, "The document you are opening contains macros or customizations." All of the form templates contain macros and/or customizations from a trusted source. Therefore, select the "Enable Macros" button to proceed with opening the form template. You can then fill in the form template and print it directly from the Web.

To save a file to your computer using Microsoft Office 97 or later version (e.g., Office 2000, XP, 2003), find the form you need from the list above and double-click on the file name (e.g., CS178.dot, for a MS Word document). After you double-click on the form template name, a window may open informing you that you are about to download an item from another server. This warning will vary based on the browser you are using. Once the form template opens, you can select the "Save As" command from your "File" menu and save the form template to your template folder (e.g., "C:/Program File/MSOffice/templates").

Once you have saved the form template to your template directory, open MS Word and select the form template from the File + New dropdown menu to create a new form document. Complete the form by tabbing through the fields and entering the requested text. Use the "space bar" or mouse to select a checkbox. The forms do not need to be unprotected in order to enter information into the fields on the forms. Use the unprotect feature of the form only to reformat the actual form. Be sure to reprotect the form, if you unprotect it, before printing it, or all of the information entered into the fields will disappear when you print the form. For more detailed information on downloading and saving the templates, see the FAQs.

Instructions for Downloading and Using the PDF Format 

Acrobat Reader is required to view, fill-in responses, and print a form in a PDF format. You cannot save the filled-in responses unless you have a license for Adobe Acrobat (however, you can save a copy of the form without your responses with just the "Reader"). Click on the yellow box to download a free copy of Acrobat Reader. MDCS_Adobe Acrobat 


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The state of Michigan is an Equal Opportunity Employer
Drug Testing Policy: All persons offered employment in the classified service are required to submit to and pass a pre-employment drug test as a condition of employment.

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