MiCSC - MCSC Forms

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 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.

Forms for State Employees and Applicants

Applications for Examinations

Forms for Managers and Personnel Staff

Your questions and comments are welcome.
Send them to the Civil Service Internet Team.
Revised: September, 2013


Form Name and Number	Microsoft Office 2003 Format	PDF Format
Adding Names to Applicant Pools for Examinations Already Taken and Passed CS-1706 *Revised 9/2010*	CS1706	CS1706.pdf
App to Continue Insurances CS-1820 This Form is for Employee Benefits, Human Resource Offices, and Retirement Use Only Revised 8/2012	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 8/2007	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
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_Leave of Absence Request_Response CS-1810 Revised 5/2012	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
Notification by Employee/Retiree of Qualifying Event CS-1766 Revised 8/2007	CS1766	CS1766.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 4/2013	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 1/2008*	CS212b	CS212b.pdf
Unclassified Position Description CS-133 *Revised 7/2013*	CS133	CS133.pdf
Verification of Eligibility CS-1830 *Revised 7/2013*	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 *New 1/2009*	CS1812	CS1812.pdf
Appointing Authority's Comments on Technical Classification Complaint CS-1627 *Revised 8/2007*	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 8/2007*	CS214	CS214.pdf
Discriminatory Harassment Work Rule Revised 8/2007	Harrass	Harrass.pdf
Employee Departure Report CS-301 *Revised 6/2011*	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.

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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.