Office of Human Resources, Diversity & Inclusion

1. Name/Address Change Form - March 2021

2. For name changes, please also update your Computer Account by submitting a ticket on the Information Technology Services webpage.

Employee Action Form:

1. Employee Action Guide - October 2022 
2. Employee Action Form - July 2021 *Complete this fillable pdf online; do not print and fill out by hand*

Transfer Sign-Off 2023Supervisor Checklist for New Employees 2023Separation Procedures and Sign-Off 2023

 Voluntary Reduction in Work Schedule (VRWS):

1. VRWS Guidelines
2. VRWS Application & Timesheet

SUNY Telecommuting Program:

1. General Information
2. SUNY Telecommuting Application and Workplan - Spring 2022

Professional Staff Performance Management Life Cycle (March 2020)

Performance Evaluations:

1. UUP Performance Program (pdf - Apr 2019)
2. UUP Performance Program (Word doc - April 2019)
3. UUP Performance Evaluation (pdf - Nov 2020)
4. UUP Performance Evaluation (Word doc - Nov 2020)
5. Frequently Asked Questions about Professional Perf Mgmt Documents
6. SMART Goal Development Support  

Extra Service

1. Instructions for Extra Service/ Dual Employment/ Also Receives - UP-6 and UP-8
2. UP-6 - Request for Approval of Extra Service for MC Employees
3. UP-8 - Request for Approval of Extra Service for UUP Employees
4. Dual Employment and Extra Service Form

Performance Evaluations:

1. Classified Performance Evaluation
2. PEF Performance Evaluation Form
3. Probation Reporting Form
4. Request to Review Personnel File - Classified - April 2023

Classified Staff Presidential Recognition Awards:

Classified Staff Presidential Recognition Award Description
Classified Staff Presidential Recognition Award Nomination Form - 2019

 Hiring Forms:

1. Instructions for Hiring Classified Employees
2. Classified Service Staff Request & Authorization (Word doc.) - Apr 2019
3. Classified Service Staff Request & Authorization (Fillable .pdf) - Apr 2019

Bid Sheets:

1. Bid Sheet: Clerical (Fillable pdf version)
2. Bid Sheet: Clerical (MS Word version)
3. Bid Sheet: Non-competitive

SUNY Telecommuting Policy

SUNY Telecommuting Policy Application

1. Productivity Enhancement Program (PEP)  for 2022
   • PEP 2023 Overview and Enrollment Form - MC & UUP (enroll 11/1/22-12/12/22)
   • PEP 2023 Program Summary - CSEA & PEF
     • PEP 2023 Enrollment Form - CSEA & PEF (enroll 11/1/22-12/12/22)
2. Health Care Provider Certification for Employee's Serious Health Condition (FMLA) - 3-23
3. Health Care Provider Certification for Family Member's Serious Health Condition (FMLA) - 3-23
4. Health Insurance Domestic Partner Enrollment Instructions and Form
5. MC Life Insurance Statement of Health
6. Confidential Medical Statement - April2023
7. Health Insurance Transaction Form - PS 404 - Jan 2023
8. Health Insurance Transaction Form Documentation Requirements (for PS-404) 
   • Pre-Tax Contribution Program (PTCP) PTCP Change Chart and PTCP Fact Sheet for NYS Active Employees Enrolled in NYSHIP
9. Health Insurance Opt-Out Attestation Form PS409 - August 2019
10. NYSHIP Request for Coverage Under the Young Adult Option
11. Flexible Spending Account (FSA):
    • FSA Enrollment Book 2023
    • FSA: Flyer 2023
12. Americans with Disabilities Act (ADA):
    • ADA Employee Accommodation Form - Fillable - Sept 2021
    • ADA Medical Form - Fillable - Sept 2021
13. Military Leave for Combat-related Healthcare Services - Nov 21

1. Retirement at Work Website (Retirement Enrollment & Management System)
2. Phased Retirement Program for Full-Time Academic Faculty
3. Request for Phased Retirement Form (Faculty)
4. Phased Retirement Program for UUP and MC Professionals
5. Request for Phased Retirement Form (MC or Professional Staff)
6. ERS (Employees' Retirement System) Registration - Form 5420
7. TRS (Teachers' Retirement System) Member Application
8. Police and Fire Membership Registration - Form PF 5022
9. Re-Employment of Retired Public Employees Policy 12-2018)
10. RSSL (Retirement System and Social Security Law) Information & Acknowledgement Form

1. Workers Compensation Instructions
2. Accident Reporting Form (Fillable) - May 2023
3. Confidential Medical Statement - April 2023
4. Workers' Compensation Claimant Information Packet
5. Workers' Compensation Pharmacy Benefits

1. Tuition Assistance - B-140W 2021
2. Tuition Assistance - UUP Space Available Form (for use at New Paltz)
3. Tuition Assistance - Technology, Athletic & Health Center Fee Waiver (NP Employees Only)

Dental Plan Forms:

Vision Plan Information:

Retirement System Forms:

Other Benefits Forms:

Leave Donation Form

Medical Statement

Retirement and Social Security Law Information & Acknowledgement Form*

• Initiate a Search
• Recruitment Plan and Affirmative Action Efforts
• Faculty Financial Guidelines
• Application for Employment
• Candidate Evaluation Form
• Candidate Recommendation Form
• Appointment Request Form
• Waiver Form