"Additional Employment Request" - City and County of San Francisco, California

Additional Employment Request is a legal document that was released by the Department of Human Resources - City and County of San Francisco, California - a government authority operating within California. The form may be used strictly within City and County of San Francisco.

Form Details:

  • Released on May 1, 2021;
  • The latest edition currently provided by the Department of Human Resources - City and County of San Francisco, California;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Department of Human Resources - City and County of San Francisco, California.

ADVERTISEMENT
ADVERTISEMENT

Download "Additional Employment Request" - City and County of San Francisco, California

Download PDF

Fill PDF online

Rate (4.6 / 5) 10 votes
Page background image
City and County of San Francisco
Department of Human Resources
City and County of San Francisco
Department of Human Resources
Carol Isen
Connecting People with Purpose
Carol Isen
Connecting People with Purpose
Human Resources Director (Acting)
www.sfdhr.org
Human Resources Director
www.sfdhr.org
Additional Employment Request
Additional Employment Request
Form Instructions
Form Instructions
To avoid conflicts of interest and incompatible activities, City employees who want to engage in any paid employment
To avoid conflicts of interest and incompatible activities, City employees who want to engage in any paid employment
in addition to their City employment (including a position with a different City department) must submit an Additional
in addition to their City employment (including a position with a different City department) must submit an Additional
before
before
Employment Request and receive approval of their Appointing Officer and the City’s Human Resources Director
Employment Request and receive approval of their Appointing Officer and the City’s Human Resources Director
starting that additional employment. Under the Civil Service Rules, Series 18, Conflict of Interest, additional
starting that additional employment. Under the Civil Service Rules, Series 18, Conflict of Interest, additional
employment includes any employment, position, or service—including business ownership, consulting, and working
employment includes any employment, position, or service—including business ownership, consulting, and working
as an independent contractor—for which an employee receives compensation in any form, including salary, wage, fee,
as an independent contractor—for which an employee receives compensation in any form, including salary, wage, fee,
commission, or emolument.
commission, or emolument.
Additional Employment Request Approval Requirements
Additional Employment Request Approval Requirements
before
before
Employees wishing to engage in additional employment must complete this form to request approval
Employees wishing to engage in additional employment must complete this form to request approval
beginning
beginning
before
before
additional employment or
additional employment or
there is a change in the conditions of an existing, approved additional employment.
there is a change in the conditions of an existing, approved additional employment.
Per Civil Service Rules, additional employment requests may be denied if:
Per Civil Service Rules, additional employment requests may be denied if:
The additional employment interferes in any way with performance of the employee’s City employment
The additional employment interferes in any way with performance of the employee’s City employment
The duties or responsibilities of the additional employment are inconsistent, incompatible or in conflict with
The duties or responsibilities of the additional employment are inconsistent, incompatible or in conflict with
the employee’s City duties or responsibilities, or those of the employee’s department or Appointing Officer
the employee’s City duties or responsibilities, or those of the employee’s department or Appointing Officer
The duties or responsibilities of the additional employment are contrary to the interests of City service in
The duties or responsibilities of the additional employment are contrary to the interests of City service in
general or could lead to situations that would discredit the City
general or could lead to situations that would discredit the City
The additional employment involves any work performed during the employee’s regular City work schedule
The additional employment involves any work performed during the employee’s regular City work schedule
The City may revoke approved additional employment based on new information that affects the approval.
The City may revoke approved additional employment based on new information that affects the approval.
Additional Employment Request Form Requirements
Additional Employment Request Form Requirements
An employee must fully complete this form, and include the following information:
An employee must fully complete this form, and include the following information:
“Work Schedule” provides the days and hours of the requested additional employment or an estimate of hours
“Work Schedule” provides the days and hours of the requested additional employment or an estimate of hours
to be worked (e.g., 3-5 hours/week)
to be worked (e.g., 3-5 hours/week)
“Amount or value of compensation” provides an estimate of compensation the employee expects to receive
“Amount or value of compensation” provides an estimate of compensation the employee expects to receive
for the additional employment
for the additional employment
”Start Date” contains a future date and “End Date” contains a date up to 12 months later than the Start Date
”Start Date” contains a future date and “End Date” contains a date up to 12 months later than the Start Date
“Job Duties” provides detail of the work the employee will perform in the additional employment. The
“Job Duties” provides detail of the work the employee will perform in the additional employment. The
description must provide sufficient detail to understand the work and identify possible conflicts, interference,
description must provide sufficient detail to understand the work and identify possible conflicts, interference,
or incompatibility with the employee’s City employment
or incompatibility with the employee’s City employment
Any employee violating the additional employment requirements is subject to disciplinary action, up to and including
Any employee violating the additional employment requirements is subject to disciplinary action, up to and including
termination of employment.
termination of employment.
th
th
One South Van Ness Avenue 4
One South Van Ness Avenue 4
Floor • San Francisco CA 94103-5413 • (415) 557-4800
Floor • San Francisco CA 94103-5413 • (415) 557-4800
City and County of San Francisco
Department of Human Resources
City and County of San Francisco
Department of Human Resources
Carol Isen
Connecting People with Purpose
Carol Isen
Connecting People with Purpose
Human Resources Director (Acting)
www.sfdhr.org
Human Resources Director
www.sfdhr.org
Additional Employment Request
Additional Employment Request
Form Instructions
Form Instructions
To avoid conflicts of interest and incompatible activities, City employees who want to engage in any paid employment
To avoid conflicts of interest and incompatible activities, City employees who want to engage in any paid employment
in addition to their City employment (including a position with a different City department) must submit an Additional
in addition to their City employment (including a position with a different City department) must submit an Additional
before
before
Employment Request and receive approval of their Appointing Officer and the City’s Human Resources Director
Employment Request and receive approval of their Appointing Officer and the City’s Human Resources Director
starting that additional employment. Under the Civil Service Rules, Series 18, Conflict of Interest, additional
starting that additional employment. Under the Civil Service Rules, Series 18, Conflict of Interest, additional
employment includes any employment, position, or service—including business ownership, consulting, and working
employment includes any employment, position, or service—including business ownership, consulting, and working
as an independent contractor—for which an employee receives compensation in any form, including salary, wage, fee,
as an independent contractor—for which an employee receives compensation in any form, including salary, wage, fee,
commission, or emolument.
commission, or emolument.
Additional Employment Request Approval Requirements
Additional Employment Request Approval Requirements
before
before
Employees wishing to engage in additional employment must complete this form to request approval
Employees wishing to engage in additional employment must complete this form to request approval
beginning
beginning
before
before
additional employment or
additional employment or
there is a change in the conditions of an existing, approved additional employment.
there is a change in the conditions of an existing, approved additional employment.
Per Civil Service Rules, additional employment requests may be denied if:
Per Civil Service Rules, additional employment requests may be denied if:
The additional employment interferes in any way with performance of the employee’s City employment
The additional employment interferes in any way with performance of the employee’s City employment
The duties or responsibilities of the additional employment are inconsistent, incompatible or in conflict with
The duties or responsibilities of the additional employment are inconsistent, incompatible or in conflict with
the employee’s City duties or responsibilities, or those of the employee’s department or Appointing Officer
the employee’s City duties or responsibilities, or those of the employee’s department or Appointing Officer
The duties or responsibilities of the additional employment are contrary to the interests of City service in
The duties or responsibilities of the additional employment are contrary to the interests of City service in
general or could lead to situations that would discredit the City
general or could lead to situations that would discredit the City
The additional employment involves any work performed during the employee’s regular City work schedule
The additional employment involves any work performed during the employee’s regular City work schedule
The City may revoke approved additional employment based on new information that affects the approval.
The City may revoke approved additional employment based on new information that affects the approval.
Additional Employment Request Form Requirements
Additional Employment Request Form Requirements
An employee must fully complete this form, and include the following information:
An employee must fully complete this form, and include the following information:
“Work Schedule” provides the days and hours of the requested additional employment or an estimate of hours
“Work Schedule” provides the days and hours of the requested additional employment or an estimate of hours
to be worked (e.g., 3-5 hours/week)
to be worked (e.g., 3-5 hours/week)
“Amount or value of compensation” provides an estimate of compensation the employee expects to receive
“Amount or value of compensation” provides an estimate of compensation the employee expects to receive
for the additional employment
for the additional employment
”Start Date” contains a future date and “End Date” contains a date up to 12 months later than the Start Date
”Start Date” contains a future date and “End Date” contains a date up to 12 months later than the Start Date
“Job Duties” provides detail of the work the employee will perform in the additional employment. The
“Job Duties” provides detail of the work the employee will perform in the additional employment. The
description must provide sufficient detail to understand the work and identify possible conflicts, interference,
description must provide sufficient detail to understand the work and identify possible conflicts, interference,
or incompatibility with the employee’s City employment
or incompatibility with the employee’s City employment
Any employee violating the additional employment requirements is subject to disciplinary action, up to and including
Any employee violating the additional employment requirements is subject to disciplinary action, up to and including
termination of employment.
termination of employment.
th
th
One South Van Ness Avenue 4
One South Van Ness Avenue 4
Floor • San Francisco CA 94103-5413 • (415) 557-4800
Floor • San Francisco CA 94103-5413 • (415) 557-4800
A
E
R
DDITIONAL
MPLOYMENT
EQUEST
Instructions: Complete Section I, have your proposed employer complete Section II, then email or hand-deliver this form to your human resources department.
EMPLOYEE INFORMATION
SECTION I
SECTION I
EMPLOYEE INFORMATION
City
Employee
Department
Name
First
Last
Job Code
City Email
& Title
Request
Change in
New
Renew
Duration
Conditions
Type
(1 Year Max)
Self-
Yes
No
Start Date
End Date
Employed?
Business
Business
Name
Address
Street Address
Business
Type
City
State
Zip
Sun
Mon
Tue
Wed
Thu
Fri
Sat
Set Work
Yes
Start
Schedule?
No-Explain Below
End
Hourly
Weekly
Monthly
Other-Explain Below
Amount or value of compensation:
$
Job
Duties/
Explanations
I understand that any additional employment not in accordance with the applicable Civil Service Rules may result in disciplinary
action up to and including termination. I understand I must track the approval end date and ensure re-approval when necessary.
I understand the City reserves the right to revoke this approval based on new information that affects the approval.
Employee’s Signature
Date
OUTSIDE EMPLOYER ACKNOWLEDGMENT
OUTSIDE EMPLOYER ACKNOWLEDGMENT
SECTION II
SECTION II
I know that the person named in Section I is regularly employed by the City and County of San Francisco, and that I am employing
that person subject to compliance with Civil Service Rules X18 series.
Name
Title
First
Last
Email
Employer’s Signature
Date
For employers that are another City and County of San Francisco department/agency, enter department's abbreviation:
If the additional employment may trigger FLSA overtime requirements, notice will be sent to you after review by DHR.
DEPARTMENTAL PERSONNEL OFFICER
SECTION III
SECTION III
DEPARTMENTAL APPROVAL
I have determined that this additional employment does not conflict with this employee’s City duties, responsibilities and work schedule.
Name
Title
First
Last
Email
Appointing Officer’s Signature
Date
SECTION IV
SECTION IV
DHR APPROVAL
DHR APPROVAL
I have determined that this additional employment does not conflict with this employee’s City duties, responsibilities and work schedule.
Comment
Name
First
Last
Director/Designee’s Signature
Date
Rev 05/2021
Page of 2