Human Resources

Forms


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).
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Benefits

Breast Cancer Screening Leave - PDF
Group Long Term Disability Insurance Program - PDF
NYS Health Insurance Transaction FormPDF
NYS Long Term Care Insurance Plan (NYPERL) Notice & Fact Sheet - PDF
Prostate Cancer Screening Leave - PDF
Salary Reduction Agreement - PDF

  Optional Retirement Program:
  • Public Retirement System Determination (ORP4) - PDF
  • Retirement Program History & Election Forms - PDF
  • Retirement Consultation Verification - Word

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Classification & Compensation

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

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Employment

Address/Telephone/Name Change Form - PDF
Employee Action Form - Word | PDF
Employee Leave Certification - PDF
Employment Eligibility Verification (I-9) - PDF
Honorarium - XLS
Leave Donation Form - PDF
Leave of Absence *Employees must contact Human Resources for consultation*
   Forms - WH-380-E, WH-380-F, WH-381, WH-382
   Facts - WHD-1420, WHD-FS28
Request for Approval of Professional Appointment - PDF
Request for Prior Service Credit - Academic - Word | PDF
Request for Prior Service Credit - Non-teaching Professional - Word| PDF
Sabbatical Leave Request Form
Verification - Start of Work (Started) - Word | PDF
Verification - Start of Work (Returned) - Word | PDF

Classified Staff:  If you have been permanently transferred appointed or reinstated to a new agency and your name is on an interdepartmental promotion eligible list(s), use this form (S-211.1) to request to have your name placed on your new agency’s departmental portion of the interdepartmental promotion eligible list(s)

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Faculty and Professional Searches

Faculty & Professional Search Guidelines
Search Committee Interview Exchange Instructions
Search Procedure Workflow

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Handbook on Appointments, Reappointments, and Promotions (HARP) for UUP - PDF

Appendix A: Department Personnel Committee (DPC) Ballot - Word | PDF
Appendix B: Academic Personnel Committee (APC) Ballot - Word | PDF
Appendix C: Conflict of Interest (COI) Form - Word | PDF
Appendix D: Suggestions for Preparing a Dossier for Reappointment, Continuing Appointment, or Promotion - PDF
Appendix E: Performance Program Form - Click Here
Appendix F: Performance Evaluation Form - Click Here
Appendix G: Request to Pause the Tenure Clock - Word | PDF
Appendix H: Request to Pause the Permanent Appointment Clock - Word | PDF
Appendix I: Emeritus Application - Word | PDF

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Payroll           

Direct Deposit of Salary Enrollment/Change Form - PDF
Dual Employment Form, UP-8 - Word | PDF
Federal Employee Withholding - Form W-4 - PDF
Honorarium - Word | PDF
New York State Employee's Withholding Allowance Certificate (IT-2104) - PDF

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Performance Program & Performance Evaluation

PP/PE Forms are located HERE

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VRWS - Voluntary Reduction in Work Schedule
VRWS Form - PDF

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Workers' Compensation

Report of Accident or Injury (other than a motor vehicle accident) - PDF

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Page modified 11/26/14