SUNY University-Wide Human Resources Manual
Forms

This page contains links to many of the forms required to be completed by either employees or SUNY human resources professionals in the administration of the human resources functions covered in this manual. While links to related forms are also available from the functional activity pages listed in the table of contents and the special topics pages provided under Orientation, this page is provided for a quick reference to all of the forms available from this site. The forms are currently available as MSWord documents or templates, as Portable Document Formatn (PDF) files (you'd need adobe acrobat installed to access them), or are available via links to source sites. Changes in these formats and the forms available from this page and this manual are on-going. Unless otherwise stated forms with direct links to them listed here are in MSWord (.doc) or (.dot) formats. Reference link information is provided for forms not actually created for and saved on this website.

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Link to Adobe Systems to download Adobe Acrobat Reader

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Application for Open-Competitive Examination for State Employment (Classified Service)
http://www.cs.state.ny.us/announ/applications/downloadourapps.htm

Application on-line for Promotional Examination (Classified Service)
http://www.cs.state.ny.us/announ/mainpages/ApplicationonLine.htm

(AC132-A) State of New York Travel Voucher (MSWord fill-in) or (PDF non fill-in)
http://nysosc3.osc.state.ny.us/agencies/travel/ac132-a.pdf

(AC160) Statement of Automobile Travel (PDF fill-in)

(AC852) Authorized Signature Form (NYS) (PDF non fill-in)
www.osc.state.ny.us/agencies/ac852.pdf

(AC873) Extra Service Voucher (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

(AC946) Tax Exemption Certificate (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in) version (See ST-129 below for Exemption Certificate for Lodging)

(AC1588) Dual Employment Approval Form (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

(AC1767) TIAA-CREF Action Request (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

(AC2772) Direct Deposit Form (PDF non fill-in) or (PDF fill-in)
http://www.osc.state.ny.us/agencies/ac2772.pdf

Address Change Form (generic to be modified by campuses -- campuses should follow instructions at top of form to make form campus specific) (MSWord fill-in)

Address Change Form - SUNY (MSWord fill-in)

(B-140W) Application for Tuition and Fee Assistance (SUNY) (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

(CC-1) New Position Description - NYS Classified Service (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

(CC-2) Application for Change in Title or Salary - NYS Classified Service (MSWord fill-in) or (PDF non fill-in)

(CC-3) Existing Position Description - NYS Classified Service (MSWord fill-in) or (PDF non fill-in)

(CSC-1) Appointing Authority Request for Pension Waiver for Classified Service Retired Public Employee (PDF non fill-in) or (PDF fill-in)
also: http://www.cs.state.ny.us/forms/csc-1.pdf (non fill-in)

(CSC-2) Appointing Authority Application for Extension of Classified Employee Leave of Absence (PDF non fill-in) or (PDF fill-in)
See also: http://www.cs.state.ny.us/forms/csc-2.pdf

Appointment Form (a template that might work for some campuses) (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Distinguished Professorships (SUNY Forms) (pdf)
http://www.sysadm.suny.edu/Provost/CEA%20Checklist%20Cover%20Sheet.pdf

Extra Service Approval Form (Approval for Extra Service Performed at Home Campus) (MSWord fill-in ) or (PDF non fill-in) or (PDF fill-in)

Financial Disclosure Form (for all employees required to file (PDF) or (E-FILE)
http://www.dos.state.ny.us/ethc/pdfs/0956.pdf
http://www.dos.state.ny.us/ethc/ethel.html

Financial Disclosure Form - Request for Individual Exemption from filing (PDF)
http://www.dos.state.ny.us/ethc/pdfs/individualform.pdf

FSLA Administrative Exemption Checklist (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

FSLA Executive Exemption Checklist (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

FSLA Professional Exemption Checklist (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

HRMS Personal Information Collection Form (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Holiday Pay Waiver (MSWord fill-in) or (HTML fill-in) or (PDF fill-in)

Immigration and Naturalization Forms
http://uscis.gov/graphics/formsfee/forms/index.htm

Internal Control Vulnerability Assessment Form (MSWord fill-in)

I-9 Form (On-line fillable form)(PDF)
http://uscis.gov/graphics/formsfee/forms/files/i-9.pdf

(IT-2104) State Withholding Form (PDF-non fill-in) or (PDF fill-in form)
http://www.tax.state.ny.us/pdf/2005/wt/it2104_2005.pdf

http://www.tax.state.ny.us/pdf/2005/fillin/wt/it2104_2005_fill_in.pdf

Leave Donation Authorization Form (MSWord fill-in) or (HTML fill-in) or (PDF non fill-in) or (PDF fill-in)

Mentee Application (Application to be mentored - SUNY's Mentoring Program for Management Staff) (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Mentor Application (Application to be a mentor - SUNY's Mentoring Program for Management Staff) (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Orientation Checklist for Human Resources Officers (MSWord)or (HTML) or (PDF) version

ORP Retirement Program History Sheet (C2752-480)

Performance Evaluation Appeal Form for CSEA, Classified M/Cs and PEF (MSWord) or (PDF non fill-in)

Performance Evaluation Appeal Form for Security Services employees (MSWord fill-in) or (PDF non fill-in)

Performance Evaluation Appeal Form for Security Supervisors (MSWord fill-in) or (PDF non fill-in)

Performance Evaluation Form for CSEA (ASU, ISU, OSU) (MSWord non fill-in) or (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Performance Evaluation Form for M/C classified service employees (MSWord non fill-in) or (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Performance Evaluation Form for PS&T (PEF) employees (MSWord non fill-in) or (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Performance Evaluation Form for Security Services employees (to be developed)

Performance Evaluation Form for SUNY Professional Employees (SUNY Original)

Performance Evaluation Form for SUNY Professional Employees (SUNY Modified Original)

Performance Program Form for SUNY Professional Employees (SUNY Original)

Performance Program Form for SUNY Professional Employees (SUNY Modified Original)

Position Description Form (SUNY) (MSWord fill-in) or (PDF non fill-in)

Prior Service Request Form for Academic Appointees

Prior Service Request Form for Professional Employee Appointees

Productivity Enhancement Program (PEP) Enrollment Form for CSEA (MSWord) or HTML) or (PDF)
(pdf) at http://www.cs.state.ny.us/attendance_leave/PEP_enroll_form.pdf

(PS-404) Health Insurance Transaction Form (MSWord) or (PDF) [for all eligible employees except graduate/teaching Assistants]
http://www.cs.state.ny.us/ebd/ebdonlinecenter/pof/images/ps404.pdf

(PS-404G) Health Insurance Transaction Form [for eligible graduate/teaching assistants]

(RS-5420.I) Employees' Retirement System Membership Registration (PDF)
http://osc.state.ny.us/retire/forms/art15membershipapp-RS5420.pdf

Salary Reduction Agreement (TDA/SRA) (MSWord) or (PDF non fill-in) or (PDF fill-in)

Separation from Employment Checklist for employees (MSWord fill-in ) or (HTML) or (PDF non fill-in) or (PDF fill-in)

(ST-129) Exemption Certificate (exempt traveler from NYS, and some other states' tax on occupancy of hotel rooms) (PDF non fill-in) or (PDF fill-in)
Non fill-in PDF also available at: http://nysosc3.osc.state.ny.us/agencies/travel/taxexempt.pdf

Suggestion Submission Form (NYS Department of Civil Service) (CMF) or (PDF)
http://www.cs.state.ny.us/esp/submitting.htm

Tax Forms - NYS
http://www.tax.state.ny.us/Forms/default.htm

(UP-3) Appointments Requiring Approval of the Chancellor or the Board of Trustees
P
rimarily used for Continuing Appointments (Academic Employees) and Permanent Appointment (Professional Employees)

(UP-6) Extra Service Approval Form (SUNY-Managerial)

(UP-8) Extra Service Approval Form (SUNY-UUP)

(UP-211) Approval to Appoint Unclassified Service Retired State Employees (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

U.S. Savings Bond Forms

Vacancy Announcement Form - (SUNY Professional Staff) (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

Voter Registration Form (PDF)
http://www.elections.state.ny.us/voting/voting.htm

(W-4) Federal Withholding Form 2005 (PDF fill-in)
http://www.irs.gov/pub/irs-pdf/fw4.pdf

Workers' Compensation Forms (PDF fill-ins)
http://www.wcb.state.ny.us/content/main/Forms.htm

Workforce Succession Planning Checklist -- Internal Control (MSWord fill-in) or (PDF non fill-in) or (PDF fill-in)

 

last updated: Thursday, March 3, 2005