CA OHR 64 2019-2025 free printable template
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PrintClearSTATE OF CALIFORNIA
ALTERNATE WORKWEEK SCHEDULE AGREEMENT
DGS OR 64 (Rev. 09/2019)DEPARTMENT OF GENERAL SERVICES
Office of Human Resources(Do not use for employees in Workweek Groups E or
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How to fill out CA OHR 64
01
Obtain the CA OHR 64 form from the official website or your local social services office.
02
Fill in your personal details at the top of the form, including your name, address, and contact information.
03
Indicate your employment history by listing the names of employers, dates of employment, and positions held.
04
Provide details of any income received, including wages, unemployment benefits, or any other sources of income.
05
Include information about your household members, such as their names, ages, and relationships to you.
06
Review the form for accuracy and completeness before signing and dating it at the bottom.
07
Submit the completed form according to the instructions provided, either by mail or in person.
Who needs CA OHR 64?
01
Individuals applying for financial assistance or public aid in California.
02
Those who have recently lost their job and are seeking unemployment benefits.
03
Households needing to report their income and employment status for eligibility determination.
04
Applicants seeking to establish their financial situation to qualify for social services programs.
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What is CA OHR 64?
CA OHR 64 is a form used by employers in California to report employee payroll information to the California Office of the Human Resources.
Who is required to file CA OHR 64?
Employers in California that have employees and are required to report wage data to the state are mandated to file CA OHR 64.
How to fill out CA OHR 64?
To fill out CA OHR 64, employers must provide accurate employee payroll data including wages, hours worked, and personal employee information as specified in the form instructions.
What is the purpose of CA OHR 64?
The purpose of CA OHR 64 is to ensure compliance with state labor laws and to provide the state with necessary data for monitoring employment practices and policies.
What information must be reported on CA OHR 64?
The information required on CA OHR 64 includes employee names, identification numbers, total hours worked, wages earned, and other relevant payroll details.
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