<p> Commonwealth of Massachusetts Human Resources Division Checklist for New Employee Orientation (2/15/05) Employee Name: Hire Date: ______Position: Employee ID: ______</p><p>Please indicate employee type (check all that apply): ___ Bargaining Unit ___ Confidential ___ TPL (Technical Pay Law) ___ Manager ___Contract* ___ Seasonal ___ Intermittent ___ Civil Service: (Select one: ____Appointment from List _____Provisional Hire _____ Other) * Denotes items below that also apply to contract employees</p><p>Please check off items below to confirm what was discussed and which documents were shared.</p><p>Section 1: Issues to Discuss Section 2: Required Documentation & Welcome Information  Organizational Chart *  Commonwealth of Massachusetts  Job Description * Application for Employment  State Government *  Standard Contract Form (for Contract Employees)* Employee Responsibilities  Contract Employee Disclosure  Work Week and Schedules * Form (Sunshine Policy)*  Attendance*  Code of Conduct or Standards of  Probationary Period Employment Signature Form  Professionalism*  I-9 Form and two forms of ID  Safety/Use of State Property*  W-4 Federal Income Tax  Job Performance Evaluations* Withholding Form *  Statement of Financial Interest (if  M-4 State Income Tax Withholding applicable)* Form *  Direct Deposit Form * Benefits and Compensation  SSA Form 1945 concerning Social  Bi-Weekly Pay Advice* Security Benefits (requires  Direct Deposit * employee signature)  Group Insurance  State Retirement System - New  Deferred Compensation Member Enrollment Form or  Dental/Vision mandated OBRA*  Miscellaneous Pay Issues  Group Insurance Commission  Leaves (GIC) Benefit Decision Guide  Extended Illness Leave Bank  GIC Employee Acknowledgement Form Career Development  CORI (certain positions)  Training*  Tuition Remission Section 3 : Other Documents (if applicable) Leaving State Service  Retirement  Recruitment paperwork and  Notice supporting documentation *  COBRA  Statement of Financial Interest</p><p>1  Request for prior service credit, information & form</p><p>2 Employee Name : ______Section 3 (cont) Section 4  Emergency Contact Data Sheet * Agency-Specific Policies (list )  Copy of required license(s) for job*  ______ GIC Insurance Enrollment and ____ Change Form (Form-1)  GIC Insurance Data Form (IDF  ______Form) and documentation ____ (marriage/birth certificates or if applicable, divorce decree.)  ______ GIC Life Insurance Beneficiary ____ Designation Form (319 one to three beneficiaries; G-500 four or more  ______beneficiaries or special designations ____ such as estate or trust)  GIC Pre-Tax Basic Life & Health Section 5: Handouts Insurance Plan - Election Not to Statewide Policies, Employment Law, Participate form Rules and Information  HMO or POS application – if one  New Employee Orientation Guide* of these plans is selected  Affirmative Action/EEO (Title VII  GIC Dental & Vision Enrollment of the Civil Rights Act of 1964)* and Change Form (Form-1)  Code of Conduct or Employment (managers and confidential Standards for Bargaining Unit employees only) Employees  Long Term Disability (LTD)  Code of Conduct for Managers and brochure Confidentials  Dependent Care Assistance  Computer Operations – Information Program (DCAP) application* Technology Policy*  Health Care Spending Account  Deduction Schedule (HCSA) application  Domestic Violence Policy  MBTA/Commuter Rail Pass (Executive Order 398) * Program  Drug Free Workplace Policy*  Introduction to Conflict of Interest Law*  Public Employees and Campaigns brochure  Sexual Harassment Policy (Title VII of the Civil Rights Act and MGL)*  Smoking Policy*  Sunshine Policy (Executive Order 444)*  Workplace Violence Prevention Policy (Executive Order 442)* </p><p>I hereby acknowledge that I have received copies of all the policies/procedures listed above in Sections 2,3, and 5 and/or have been given guidance on where I can find these policies online. I understand that it is my responsibility to read and comply with all policies, rules and regulations. I have discussed all the items in Sec. 1 and have received all the necessary forms in Sec. 2+3. If I have any questions, I will contact a Human Resources Representative. Signatures: 3 ______Employee* Date*</p><p>______Human Resources Representative/Agency Manager Date* Duplicate signed copy be to given to employee. Original copy to be kept in Personnel File</p><p>4</p>