Bilingual Pay Authorization Form - State Of California
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STATE OF CALIFORNIA
BILINGUAL PAY AUTHORIZATION
STD. 897 (REV. 4/95)Page 1
EFFECTIVE DATE
1. DEPARTMENT
2. POSITION NUMBER
Agency Code
Unit Code
Class Code
Serial
( First Name)
( M. I.)
3. EMPLOYEE NAME (Last Name)
5 SOCIAL SECURITY NUMBER
4. CLASS TITLE (For reclassification, enter new class)
BILINGUAL JUSTIFICATION
A bilingual position requires the use of a bilingual skill 10 percent of the time in order for the incumbent to be eligible for bilingual pay. Positions
must be in a setting where there is a demonstration of client or correspondence flow showing that bilingual skills are clearly needed. The
skills may be used to meet the needs of the public in a direct public contact position; or a hospital or institution setting dealing with patient
or inmate needs; or performing interpretation, translation, or other specialized bilingual tasks for the department and its clients. More
detailed instructions are available in the Bilingual Pay Manual available from the Department of Personnel Administration. Enter in Item
6 the language used by the employuee using the four-place language codes listed below.
Language
Code
Language
Code
Language
Code
Language
Code
Spanish
SPAN
Arabic
ARBC
Braille
BRAI
Hindustani
HNDU
Tagalog
TAGA
Chinese (Cantonese) CHCA
Vietnamese
VIET
Japanese
JAPN
Ilocano
ILOC
Chinese (Mandarin)
CHMA
Portuguese
PORT
Russian
RUSS
Punjabi
PUNJ
Sign Language
SIGN
Korean
KORE
6. LANGUAGE USED
7. TENURE
8. TIME BASE
PERMANENT
LIMITED TERM
FULL TIME
PART TIME
VERBAL
WRITTEN
INTERMITTENT
9.A. DATE EMPLOYEE PASSED THE
B. WAS THIS THE FIRST TIME EMPLOYEE PARTICIPATED IN THE EXAM?
10. DATE EMPLOYEE FIRST ASSUMED BILINGUAL DUTIES MEETING BSP*
STATE FLUENCY EXAMINATION
CRITERIA (10% of work time)
YES
NO (If NO, enter date first exam taken)
11. REASON FOR REQUEST
ENTER OLD CLASS
ARE BILINGUAL DUTIES SUBSTANTIALLY THE SAME?
RECLASSIFICATION (If employee is already receiving bilingual pay and
A.
YES
NO (If NO, explain in Item 15.A.)
has a change in classification, complete Itens 1 through 16. J.)
B.
NEW POSITION FOR WHICH BILINGUAL PAY HAS NEVER BEEN REQUESTED. (Complete all Items 1. through 16.J.)
ARE BILINGUAL DUTIES SUBSTANTIALLY THE SAME AS
ENTER LAST INCUMBENT
THOSE PERFORMED BY THE LAST INCUMBENT?
REFILLING VACANT POSITION FOR WHICH BILINGUAL PAY WAS
C.
NO (If NO, explain in Item 15.A.)
YES
PREVIOUSLY APPROVED .
D.
TERMINATE BILINGUAL PAY—EMPLOYEE CEASED TO MEET BSP* CRITERIA OR VACATED THE POSITION. (Complete all Items 1. through 8. and 14.)
(Complete Items 1, 2, 4, 5
E.
REMOVE THIS POSITION FROM BILINGUAL PAY STATUS—CLIENTELE OF THIS LOCATION LOWERED TO THE DEGREE THAT BSP* CRITERIA CANNOT BE MET.
through 8., 12., and 14.)
F.
ESTABLISH BILINGUAL PAY—CHANGE IN INCUMBENT'S DUTIES OR CASE LOAD. (Complete Items 1. through 15.J.)
12. WORK ADDRESS OF EMPLOYEE
A. EXACT OFFICE OR UNIT TITLE AND DISTRICT IN WHICH EMPLOYEE WORKS
C. LOCATION CODE (To be
completed by the depart
mental bilingual pay coor
dinator)
B. ADDRESS (List Street Address, City and Zip Code) WHERE EMPLOYEE WORKS
13. EMPLOYEE AND SUPERVISOR SIGNATURES (The undersigned certify that the information contained in this document is true and correct.)
A. EMPLOYEE
B. TELEPHONE NUMBER
C. DATE SIGNED
D. IMMEDIATE SUPERVISOR
E. TELEPHONE NUMBER
F. DATE SIGNED
14. AGENCY APPROVAL
A. BILINGUAL COORDINATOR
C. DATE SIGNED
B. TELEPHONE NUMBER
*BSP - Bilingual Salary Program
(CONTINUE ON REVERSE)
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