Human Resources Forms

Human Resources
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Form NameFile Type
Compliance Assistance Family and Medical Leave Act
CSEA LEAP Applications
Dental Claim Form (CSEA)
Dental Claim Form (MC and Council 82)
Dental Claim Form (UUP)
Dependent Care Advantage Account
Domestic Partner Instructions/Forms
Empire Plan Health Insurance Claim Form
Employee Assistance Program
Faculty & Staff Apple Discount Program
Faculty & Staff Dell Discount Program
Flexible Spending 2015 Enrollment Campaign
Health Care Spending Account
Helpful Telephone Numbers
NYS Balance: Resources and Referral
SUNY Benefits Information
SUNY Perks
Tuition Waiver - MSC UUP Space Available
Tuition Waiver Form (B-140W)
UBMicro Computer and Software Discounts
Vision Claim Form (CSEA)
Vision Claim Form (MC)
Vision Claim Form (UUP)
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Extra Service

Form NameFile Type
Dual Employment/Extra Service Approval Form (AC1588)
Extra Service Authorization Form
Extra Service Payroll Voucher (AC873)
UP6 Extra Service Form (M/C)
UP8 Extra Service Form (UUP)
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Form NameFile Type
Report of Accident or Injury
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Payroll Forms

Form NameFile Type
Change of Address
Direct Deposit Form (AC2772)
Employment Eligibility Verification Form (I-9)
Federal Withholding Tax Form W-4
Holiday Report
Hourly Temp Service Employee Payroll Schedule 2015
Hourly Temp Service Student Payroll Schedule 2015
NYS Withholding Tax Form IT 2104
Overtime Report
Retirement Form for Part Time Employees
Salary Reduction Agreement - SUNY 403(b) Voluntary Savings Plan
Time Sheet - Professional
Time Sheet - Classified
Time Sheet - Student Temporary Services
Time Sheet - Temporary Services
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Performance Program & Evaluation

Form NameFile Type
CSEA Performance Evaluation
UUP Performance Evaluation
UUP Performance Program
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Form NameFile Type
Appointment Action Request for Classified Service
Appointment Request Form (For Academic and Professional Staff)
Employment Application - Faculty/Professional Staff
Employment Application - Support/Classified Staff
Recruitment Authorization
Summer Employment Application - Student Temporary
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