fredonia.edu : Human Resources : Forms - Human Resources, SUNY Fredonia

Human Resources

 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).

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Benefits

Breast Cancer Screening Leave Word | PDF
Group Long Term Disability Insurance Program Word | PDF
NYS Health Insurance Transaction Form PDF
Prostate Cancer Screening Leave Word | 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 Word | PDF
New Position Description Word | 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 Word | PDF 
Request for Approval of Professional Appointment PDF
Request for Leave of Absence Word | PDF
Request for Leave of Absence, Instructions PDF 
Request for Prior Service Credit - Academic Word | PDF
Request for Prior Service Credit - Non-teaching Professional Word | PDF
Request for Sabbatical Leave Word
Verification - Start of Work (started) Word | PDF
Verification - Start of Work (returned) 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 & Evaluation

All forms are located HERE

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Workers Compensation

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

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Page modified 5/17/12