Directory of Administration and Finance Forms
For questions regarding individual forms, please contact the owner listed.
Click on the column title to sort or use CTRL+F to search for keywords.
|Accident Report, Student and Visitor (CS-13)||To be completed by students or visitors who have an accident on campus.||Environmental Health & Safety|
|Address Change Form (PDF)||For inactive employees to change their home address. Active employees should change their address in the SUNY Portal.||Human Resource Services|
|Agency Account Check Request||To be completed when a check needs to be issued. Please refer to the policy and procedure document above for specific instructions on how the forms should be completed.||CAS|
|Agency Account Deposit Form||To be completed when making deposits to an agency account. Please refer to the policy and procedure document above for specific instructions on how the forms should be completed.||CAS|
|Agency Account Application and Fiscal Agent Agreement||To request and authorize CAS to act as its fiscal agent for the receipt, custody and disbursements of funds. Please refer to the policy and procedure document above for specific instructions on how the forms should be completed.||CAS|
|Alleged Safety or Health Hazards, Notice of||To report an observed potential safety or health hazard for investigation.||Environmental Health & Safety|
|Asset Relocation Form||To move equipment with a SUNY Property Control barcode to another room or location.||Management Services|
|Automobile Travel, Statement of (AC 160)||
Filed with a travel voucher if you are claiming reimbursement for personal automobile mileage.
|Budget Allocation Transfer||
To process allocation transfers within or between accounts. Allocation transfers cannot
be processed between funds.
|Budget and Financial Reporting Services|
|Cancer Screening Leave Form (Fillable MS Word)||Used to document leave for cancer screening purposes.||Human Resource Services|
|Car Rental, Authorization to Expedite||Used in lieu of a travel card authorization to reserve a rental using a Purchase Order (PO). When using this form, no Purchase Requisition is necessary.||Accounts Payable|
|Car Rental, Personal vs. Rental Vehicle Cost Comparison||
Used to calculate the cost comparison of taking a personal vehicle vs. a rental vehicle
and to document that the choice made was at the lowest cost to the state.
|Chemical Purchase Form||To place orders for studios, laboratories and/or research.||Environmental Health & Safety|
|Child and Youth Protection Training Acknowledgment||To acknowledge participation and understanding of biennial training by covered persons.||Management Services|
|Covered Persons Sex Offender Registry Check Clearance||To be completed by covered person(s) involved in an event involving children prior to event.||Management Services/University Police|
|CP-3 (Reappointment or Change In Status Form) (MS Word)||Reappointment or Change in Status request for Unclassified Employees (UUP or M/C). Need Help Completing the CP-3 Form? View instructions.||Human Resource Services|
|CP-3a (Adjunct Reappointment Form) (MS Word)||To reappoint part-time academic employees in adjunct titles. Need Help Completing the CP-3a Form? View instructions.||Human Resource Services|
|CSEA Annual Performance Evaluation Form (MS Word)||To evaluate employees represented by CSEA.||Human Resource Services|
|Customer Comment Card (PDF)||To tell us about your interaction with Human Resource Services||Human Resource Services|
|Direct Deposit Form||Attach a copy of a voided check or stop to your bank to have it completed before submitting to Payroll.||Payroll Services|
|Electronic Equipment Transfer/Disposal Form||To dispose or transfer ownership of equipment that is no longer working, outdated, or no longer needed and has a memory (i.e. hard drives, printers, etc.)||Management Services|
|Employee Accident Report||To be completed by all employees when they have an accident while performing work
responsibilities, which includes driving.
Instructions: Employee Accident Reporting Brochure.
|Human Resource Services / Environmental Health & Safety|
|Employee Safety Concerns||To report an experience that occurred to you for investigation and/or remediation.||Environmental Health & Safety|
|Employee's Withholding Allowance Certificate (W-4), Federal||To report your federal income tax from your pay.||Payroll Services|
|Employee's Withholding Allowance Certificate (IT-2104), State||To report your state income tax from your pay.||Payroll Services|
|Student Employment Verification Form (I-9)||May be filled out in advance, but must be presented with original documentation when submitting to the appropriate office.||Payroll Services|
|Employment Verification Form (I-9)||May be filled out in advance, but must be presented with original documentation when submitting to the appropriate office. State employees submit to Human Resource Services.||Human Resource Services|
|Equipment Transfer/Disposal Form||To dispose or transfer ownership of equipment that is no longer working, outdated, or no longer needed and does not have a memory (i.e. hard drives, printers, etc.)||Management Services|
|Exemption from Sexual Molestation Insurance Requirements, Request for||To request exemption from third-party liability policy coverage no less than one million ($1,000,000).||Management Services|
|Exemption from Withholding Certificate (IT-2104-E)||Payroll Services|
|Expedite Purchase, Authorization||Accounts Payable|
|Exposure Incident Report Forms||To report exposure to blood-borne pathogens (i.e. needle sticks).||Environmental Health & Safety|
|Departmental Funding Limitation||Please note: This form has been incorporated into the Travel Voucher and the separate standalone form is no longer being used.||Accounts Payable|
|Foreign Status of Beneficial Owner for US Tax Withholding (W-8BEN)||To be completed at the same time as the Foreign Vendor Registration. Required for all new foreign vendors.||Purchasing Services|
|Foreign Vendor Registration Request||To set up a new foreign vendor in the NYS State Financial System||Purchasing Services|
|Employee Suggestion Form (MS Word)||To submit suggestions that can result in specific improvements, cost savings, or other enhancements to the campus.||Human Resource Services|
|Ethics - Honorarium Approval Form (Fillable MS Word)||Approval form for Joint Commission on Public Ethics for Honorarium.||Human Resource Services|
|Ethics - Official Activity Expense Payment or Service Payment Form (Fillable MS Word)||Approval form for Joint Commission on Public Ethics.||Human Resource Services|
|FMLA - Certification of Health Care Provider for Employee's Serious Health Condition (PDF)||Documentation to determine eligibility for FMLA due to employee's serious health condition. For additional information, see FMLA.||Human Resource Services|
|FMLA - Certification of Health Care Provider for Family Member's Serious Health Condition (PDF)||Documentation to determine eligibility for FMLA due to a family member's serious health condition. For additional information, see FMLA.||Human Resource Services|
|Health Insurance Transaction Form PS-404 (PDF)||To enroll or make changes to your health insurance record. For additional information, see Health Insurance.||Human Resource Services|
|High Risk Asset Log||To inventory equipment items that are pilferable and less than $2,500.||Management Services|
|Hold Sponsored Activity Involving Children, Request to||To request an College or a college-affiliated organization event or activity involving children on campus.||Management Services|
|Inventory Box Label||To label inactive records sent to storage||Management Services|
|Journal Expenditure Transfer||To transfer expenses from one account to another.||Accounts Payable|
|Leave Donation Form (Fillable MS Word)||To donate vacation accruals for the recipient to use as sick leave.||Human Resource Services|
|LENS Release||LENS Release for Operation of a State/Owned/Operated/Leased/Rented or CAS Vehicle on State Business.||University Police|
|Mileage Breakdown||Used to breakdown the cost of mileage when using a personal vehicle versus a rental vehicle.||Accounts Payable|
|Name Change Form (PDF)||To change your legal name due to marriage/divorce or court order. Supporting documentation is required.||Human Resource Services|
|Near Miss Accident Report||To document an unplanned incident that occurred that may have resulted in personal harm or injury and can be remediated to eliminate future accidents.||Environmental Health & Safety|
|Net Card Application||Please note: This form has been incorporated into the Travel/Net Card Application and the separate standalone form is no longer being used.||Accounts Payable|
|Non-employee Travel Expense||
Completed after travel to account for costs incurred and to request reimbursement
for travel expenses for non-employees.
|Notice of Privacy Practices (Protected Health Information) Acknowledgment||To complete after reading and reviewing the campus' Notice of Privacy Practices.||Management Services|
|Over Per Diem Lodging Justification||Justifies lodging that exceeds per diem rates.||Accounts Payable|
|Personal Information Form (Fillable)||To change personal information such as gender, ethnicity, military status, or emergency contacts.||Human Resource Services|
|Procurement Card Application||Complete to be issued a Citibank procurement card.||Purchasing Services|
|Purchase Requisition||Authorization for a purchase.||Purchasing Services|
|StaplesLink Online Order Registration||To set up an online account to make P-card purchases through Staples/Proftech||Purchasing Services|
|State Card Acknowledgment||Outlines terms and conditions for use of Procurement (P-Card), Travel Card, and Non-Employee Travel (NET) Card.||Accounts Payable|
|State Vehicle Request||To use a state vehicle for official business||Facilities|
|Standard Voucher (AC 92)||To be completed when making payments to vendors.||Purchasing|
|Statement in Lieu of Oath (PDF)||State Employee Statement in Lieu of Oath Pursuant to Civil Service Law §62||Human Resource Services|
|Supervisor Accident Investigation||To document supervisors' meeting with the employee after an accident and findings
of their investigations.
Instructions: Supervisor's Guide to Accident Reporting Brochure
|Environmental Health & Safety|
|Spill Report||To document petroleum-based spill of over five gallons onto land or into a waterway.||Environmental Health & Safety|
|SUNY Tuition Waiver (PDF)||All state and research foundation employees are eligible to apply for one course (1 - 6 credits) per fiscal year at a SUNY school (benefit prorated for part-time employees). For additional details, please see the Employee Tuition Waiver page.||Human Resource Services|
|Tax Exempt Certificate (AC 946)||To certify the exemption of sales tax for goods and services for employees making purchases while performing official duties.||Purchasing Services|
|Tax Exempt, New York City Occupancy||
Please note: This form is no longer needed. Travelers should submit an ST-129 for travel in New York City to request occupancy tax exemption.
|Tax Exempt, Occupancy of Hotel or Motel Rooms (ST 129)||To certify the exemption from paying state-administered New York
State and local sales taxes during official New York State business and staying in a hotel or motel (not New York City).
|Taxpayer Identification Number and Certification (AC-3237)NYS||New domestic vendor completes this form to enter the NYS State Financial System||Purchasing Services|
|Temporary Loan of Equipment||To temporarily locate campus equipment for a specific time period.||Management Services|
|Tenure Clock Stop Form (Fillable MS Word)||Request to stop the clock toward continuing or permanent appointment for birth/adoption/foster care placement of a child.||Human Resource Services|
|Third Party Reimbursement (Non-Salary)||Accounts Payable / Accounting|
|Travel Ban, Exemption Request||
Used to request an exemption to travel to a location that is currently under a travel ban.
|Accounts Payable / Management Services|
|Travel / Net Card Application||Application for Citibank Visa Travel or Non-Employee Travel Card.||Accounts Payable|
Travel Form, Authorization & Advance (Online)
|Completed prior to trip and/or when requesting an advance on certain travel expenses. The online version is preferred, but the paper version is still available for use.||Accounts Payable|
This form should be used by State Travelers who conduct routine travel throughout a semester or fiscal year. Travelers who do not conduct routine, repeated travel should use the standard Travel Authorization and Advance Form.
|Travel Voucher (AC 132-A)||Completed after travel to account for costs incurred and to request reimbursement for travel expenses. NYS Travel Voucher Application (Instructions)||Accounts Payable|
|Traveler Checklist||Assists travelers with preparing for state travel and includes important reminders of actions that should be taken before, during, and after travel has occurred.||Accounts Payable|
|UP-8P Request for Extra Service Form (Fillable MS Word)||Request for Extra Service/Other Service for all employees except M/C.||Human Resource Services|
|UUP Professional Performance Review Transmittal Form (PDF)||Must be attached to the review file of each UUP professional employee undergoing evaluation for reappointment, permanent appointment, annual review, or promotion. For additional forms, memos, and calendars related to this process, see Employee Evaluations.||Human Resource Services|
|UUP Tuition Waiver (PDF)||All UUP-represented employees are allowed to take one course per semester or session on a space-available basis. Please complete the application and return to Human Resource Services for approval/processing.||Human Resource Services|
|Van Drivers, Application for (PDF)||Approval request to be a volunteer Student Van Driver.||Human Resource Services|
|Violence Incident Report Form (Fillable MS Word)||A reportable violent incident should be defined as any threatening remark or overt act of physical violence against a person(s) or property whether reported or observed.||Human Resource Services|
|Voluntary Phased Separation Program Application (PDF)||This program is designed to give eligible employees an opportunity for a phased approach to separation. It allows individuals to move into non-employment or retirement gradually through a voluntary reduction in work and commensurate reduction in pay. For additional information, see the complete Program Description.||Human Resource Services|
|Voluntary Reduction Work Schedule (VRWS) Application for CSEA/PEF/MC (Fillable MS Word)||This program allows CSEA, PEF, or MC (06) employees to voluntarily trade income for time off. See your Collective Bargaining Agreement for additional details specific to your negotiating agreement. Chart to determine VR Time Earned (PDF)||Human Resource Services|
|Voluntary Reduction Work Schedule (VRWS) Application for UUP (Fillable MS Word)||This program allows UUP employees to voluntarily trade income for time off. See your Collective Bargaining Agreement for additional details specific to your negotiating agreement. Chart to determine VR Time Earned (PDF)||Human Resource Services|
|Voluntary Reduction Work Schedule (VRWS) Schedule 2019-20 (PDF)||
Schedule for use of VR credit for the 2019-2020 fiscal year.
|Human Resource Services|
|Voluntary Reduction Work Schedule (VRWS) Schedule 2020-21 (PDF)||
Schedule for use of VR credit for the 2020-2021 fiscal year.
|Human Resource Services|
|Waiver of Holiday Compensation - UUP||Waiver of compensatory time for required holiday work for UUP-represented employees. Must be completed between July 1 and August 15.||Payroll Services|
|Volunteer, Application for (PDF)||Approval request to render volunteer services to SUNY Plattsburgh or to request access to other campus services.||Human Resource Services|
|Waiver of Holiday Compensation||
To elect to waive holiday compensation and choose to receive instead compensatory
time off for holidays worked. Must be completed between April 1 and May 15. For
all state employees except UUP.
|Waste Determination Form||Whether or not a waste product from a laboratory experiment is considered hazardous waste or not must be determined by the professor conducting the experiment and the proper method of disposal documented.||Environmental Health & Safety|
|Wildlife/Rabies Vector Species, Report of||To document the presence of wildlife and/or a species capable of carrying rabies on campus (i.e. bats) A determination must be made as to whether or not there was any possibility of human exposure to rabies as it is a fatal disease.||Environmental Health & Safety|
|Work Location Application (PDF)||
Used by current Cleaners or Janitors with permanent appointment to request a change to their work location.
|Human Resource Services|
For questions regarding individual forms, please contact the owner listed.