Forms

Benefits | Classification & Compensation | Employment | Ethics | Miscellaneous | Payroll | Performance Program & Evaluation | Workers Compensation

The following forms are in Microsoft Word or PDF format and can be downloaded and printed for your convenience. Download free Adobe Acrobat Reader to view forms in portable document format (PDF).

Benefits
Asset Allocation Questionnaire Word \| PDF Breast Cancer Screening Leave Word \| PDF Designation of Beneficiary for the Survivor's Benefit Program PDF Graduate Assistant Retirement Declination Form Word \| PDF Group Long Term Disability Insurance Program Word \| PDF NYS Health Insurance Transaction Form PDF NYS Government Employees' Health Insurance Coordination of Benefits Word \| PDF Prostate Cancer Screening Leave Word \| PDF Salary Reduction Agreement PDF Optional Retirement Program: Public Retirement System Determination (ORP4) PDF Retirement Program History Sheet PDF Retirement Declination Form Word \| PDF Retirement System Declination Form PDF [ Back to Top ]

Benefits

Asset Allocation Questionnaire Word | PDF
Breast Cancer Screening Leave Word | PDF
Designation of Beneficiary for the Survivor's Benefit Program PDF
Graduate Assistant Retirement Declination Form Word | PDF
Group Long Term Disability Insurance Program Word | PDF
NYS Health Insurance Transaction Form PDF
NYS Government Employees' Health Insurance Coordination of Benefits Word | PDF
Prostate Cancer Screening Leave Word | PDF
Salary Reduction Agreement PDF

Optional Retirement Program:

Public Retirement System Determination (ORP4) PDF
Retirement Program History Sheet PDF

Retirement Declination Form Word | PDF
Retirement System Declination Form PDF

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Classification & Compensation
Application for Change in Title or Salary PDF Existing Position Description Word \| PDF New Position Description Word \| PDF [ Back to Top ]

Classification & Compensation

Application for Change in Title or Salary PDF
Existing Position Description Word | PDF
New Position Description Word | PDF

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Employment
Address/Telephone/Name Change Form PDF Application for Appointment PDF Employee Action Form Word \| PDF Employee Leave Certification PDF Employment Eligibility Verification (I-9) PDF Leave Donation Form Word \| PDF Request for Approval of Professional Appointment PDF Request for Leave of Absence Word \| PDF Request for Prior Service Credit Word \| PDF UUP Sabbatical Leave PDF Verification - Start of Work (started) Word \| PDF Verification - Start of Work (returned) Word \| PDF [ Back to Top ]

Employment

Address/Telephone/Name Change Form PDF
Application for Appointment PDF
Employee Action Form Word | PDF
Employee Leave Certification PDF
Employment Eligibility Verification (I-9) PDF
Leave Donation Form Word | PDF
Request for Approval of Professional Appointment PDF
Request for Leave of Absence Word | PDF
Request for Prior Service Credit Word | PDF
UUP Sabbatical Leave PDF
Verification - Start of Work (started) Word | PDF
Verification - Start of Work (returned) Word | PDF

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Ethics
Disclosure Statement for Certain Academic Employees Word \| PDF [ Back to Top ]

Ethics

Disclosure Statement for Certain Academic Employees Word | PDF

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Miscellaneous
Civil Service Exam Application United States Savings Bond Authorization Form PDF Vehicle Registration Data Waiver of Additional Money for Holiday Work Word \| PDF Confirmation of Declination-Regular Eligible List Word \| PDF Request for Eligible List Status Change Word \| PDF Request to Change Individual Status on Interdepartmental Promotion Eligible Lists Word \| PDF [ Back to Top ]

Miscellaneous

Civil Service Exam Application
United States Savings Bond Authorization Form PDF
Vehicle Registration Data
Waiver of Additional Money for Holiday Work Word | PDF
Confirmation of Declination-Regular Eligible List Word | PDF
Request for Eligible List Status Change Word | PDF
Request to Change Individual Status on Interdepartmental Promotion Eligible Lists Word | PDF

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Payroll
Direct Deposit of Salary Enrollment/Change Form PDF New York State Employee's Withholding Allowance Certificate (IT-2104) PDF Form W-4 PDF [ Back to Top ]

Payroll

Direct Deposit of Salary Enrollment/Change Form PDF
New York State Employee's Withholding Allowance Certificate (IT-2104) PDF
Form W-4 PDF

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Performance Program & Evaluation
Annual Performance Evaluation Form - Classified Staff Word \| PDF Performance Evaluation for Managerial/Confidential Employees Word \| PDF Performance Evaluation Program - Professional, Scientific, and Tech. Services Unit PDF Performance Program for Managerial/Confidential Employees Word \| PDF Performance Program for Non-Teaching Professionals Word Probationary Period Evaluation for Classified Staff Word \| PDF Employee Performance Evaluation Rating Form: Security Services Unit Employees PDF Security Supervisor Unit Employees PDF [ Back to Top ]

Performance Program & Evaluation

Annual Performance Evaluation Form - Classified Staff Word | PDF
Performance Evaluation for Managerial/Confidential Employees Word | PDF
Performance Evaluation Program - Professional, Scientific, and Tech. Services Unit PDF
Performance Program for Managerial/Confidential Employees Word | PDF
Performance Program for Non-Teaching Professionals Word
Probationary Period Evaluation for Classified Staff Word | PDF

Employee Performance Evaluation Rating Form: