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Directory of Human Resource Services Forms


 

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Listed Alphabetically
Form Description Owner
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
Application for Volunteer (PDF) Approval request to render volunteer services to SUNY Plattsburgh or to request access to other campus services. Human Resource Services
Application for Van Drivers (PDF) Approval request to be a volunteer Student Van Driver. Human Resource Services
Cancer Screening Leave Form (Fillable MS Word) Used to document leave for cancer screening purposes. Human Resource Services
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
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
Employee Accident Report (PDF) To report a work-related accident, complete and forward to Human Resource Services.  For additional information, see Workers' Compensation. 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
Leave Donation Form (Fillable MS Word) To donate vacation accruals for the recipient to use as sick leave. Human Resource Services
Name Change Form (PDF) To change your legal name due to marriage/divorce or court order. Supporting documentation is required. Human Resource Services

Personal Information Form (Fillable MS Word)

To change personal information such as gender, ethnicity, disability status, military status, or emergency contacts. Human Resource Services
Statement in Lieu of Oath (PDF) State Employee Statement in Lieu of Oath Pursuant to Civil Service Law §62 Human Resource Services
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
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
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
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
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
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
VRWS Schedule 2019-20 (PDF)

Schedule for use of VR credit for the 2019-2020 fiscal year.

Human Resource Services
VRWS Schedule 2020-21 (PDF)

Schedule for use of VR credit for the 2020-2021 fiscal year.

Human Resource Services
Work Location Application (PDF)

Used by current Cleaners or Janitors with permanent appointment to request a change to their work location.

Human Resource Services
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