Most of the forms provided here are in Adobe Portable Document Format (PDF). You must install Adobe Acrobat Reader before you can print these forms. To use our fill-in forms, you must install Adobe Acrobat Reader version 4.0 or greater. Acrobat Reader is downloadable for free. You can also obtain these forms from Human Resource Services at 390 Administration Building or by calling (631) 632-6161.


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Hide details for Appointment/ChangeAppointment/Change
Multiple documents IconDisclosure FormHRSF0069
Multiple documents IconEmployee Demographic Data FormHRSF0019
Multiple documents IconEmployment Eligibility Verification (I-9)I-9
Multiple documents IconNotification of Change in ShiftSHIFTCHG
Multiple documents IconPermanent Appointment ProcessHRSF0132
Multiple documents IconRequest for Approval of the Employment of a Retired Public Employee in the Unclassified ServiceUP211
Multiple documents IconRequest to Change Primary (Legal) NameHRSF0046
Multiple documents IconState GA/TA Demographic Data FormHRSF0001
Multiple documents IconState GA/TA (Appointment/Reappointment/Change) Form (Fall 2013)HRSF0073
Multiple documents IconState GA/TA (Appointment/Reappointment/Change) Form (Spring 2013)HRSF0098
Multiple documents IconState GA/TA (Appointment/Reappointment/Change) Form (Summer 2013)HRSF0052
Multiple documents IconState Oath AffidavitDOS-1690
Hide details for BenefitsBenefits
Multiple documents Icon2010 Retirement Incentive Eligibility Comparison ChartHRSD0098
Multiple documents Icon2013 Health Insurance Rates (NYSHIP)HRSD0099
Multiple documents IconApplication for Tuition and Fee AssistanceB-140W,B-140-Wi
Multiple documents IconBenefits Summary - M/CHRSD0062
Multiple documents IconBenefits Summary - State ClassifiedHRSD0121
Multiple documents IconBenefits Summary - UUPHRSD0065
Multiple documents IconChoices Book - CSEA, MC, PEF, APSU, Council82, NYSCOPBA EmployeesHRSD0117
Multiple documents IconChoices Book - UUP EmployeesHRSD0116
Multiple documents IconCOBRA Request LetterHRSF0054
Multiple documents IconCouncil 82 Full-time and Part-time Employees Fringe BenefitsHRSD0040
Multiple documents IconCSEA Classified Service Full-time and Part-time Employees Fringe BenefitsHRSD0041
Multiple documents IconCSEA Dental Claim FormCSEADENTAL
Multiple documents IconDelta Dental Claim Form590122
Multiple documents IconDomestic Partner ApplicationPS-425
Multiple documents IconEarly Retirement Incentive Program and Voluntary Separation Program Non-Binding Notice of Interest FormHRSF0115
Multiple documents IconERS ApplicationHRSF0127
Multiple documents IconGHI Dental Claim FormD437B
Multiple documents IconGraduate Student Employee - Continuation of Health Insurance (For Summer Only)HRSF0043
Multiple documents IconGroup Long Term Disability Insurance Program Statement of EligibilityHRSF0121
Multiple documents IconHealth Insurance Opt-Out Program Attestation Form (For M/C, CSEA, and PEF employees only)HRSF0125
Multiple documents IconHealth Insurance Rates 2011HRSD0101
Multiple documents IconLifeWorks ProgramHRSD0036
Multiple documents IconNew York State Employees' Retirement System ApplicationRS5420
Multiple documents IconNYPERL Notice and Fact SheetHRSF0120
Multiple documents IconNYPERL NYS Employee Notice and Fact SheetHRSD0114
Multiple documents IconNYS Health Insurance Transaction Form (Non-Student Employees)PS-404
Multiple documents IconNYS Health Insurance Transaction Form (TA/GA Health Insurance Enrollment Form)PS-404G
Multiple documents IconNYSHIP Option Transfer MemoHRSD0120
Multiple documents IconOver 40 Comp Time II Pilot Program Enrollment FormHRSF0105
Multiple documents IconRequired documents for health insurance enrollmentHRSD0111
Multiple documents IconRetirement comparison for new Tier 6HRSD0113
Multiple documents IconRetirement Election FormHRSF0126
Multiple documents IconRetirement ProgramsHRSD0112
Multiple documents IconState Graduate Student Employee Benefits at a GlanceHRSD0008
Multiple documents IconSUNY 403(b) Voluntary Savings Plan Salary Reduction AgreementHRSF0106
Multiple documents IconSUNY Voluntary Savings Program MemoHRSD0066
Multiple documents IconSurvivor's Benefit ProgramRS6357
Multiple documents IconTax Deferred SavingsHRSD0095
Multiple documents IconThe Empire Plan Health Insurance Claim FormOWCP-1500
Multiple documents IconTIAA-CREF ApplicationHRSF0129
Multiple documents IconTIAA-CREF Voluntary Retirement Savings Enrollment ApplicationHRSF0091
Multiple documents IconTRS ApplicationHRSF0128
Multiple documents IconUniversal Availability NoticeHRSD0096
Multiple documents IconUUP Assistance Eligibility FormHRSF0004
Hide details for Classification and CompensationClassification and Compensation
Multiple documents IconFinal FLSA Regulations - Compliance Checklist - Administrative ExemptionHRSD0030
Multiple documents IconFinal FLSA Regulations - Compliance Checklist - Computer ExemptionHRSD0027
Multiple documents IconFinal FLSA Regulations - Compliance Checklist - Executive ExemptionHRSD0028
Multiple documents IconFinal FLSA Regulations - Compliance Checklist - Professional ExemptionHRSD0029
Multiple documents IconGeneric Position DescriptionsSUSB0037 - RF - Postdoc Generic,SUSB0037 - RF - Senior Postdoc Generic,SUSB0037 - State - Postdoc Generic
Hide details for DeductionsDeductions
Multiple documents IconPayroll Parking Deduction AuthorizationHRSF0059
Multiple documents IconState SRA 2009 Salary Reduction AgreementHRSF0099
Hide details for Direct DepositDirect Deposit
Multiple documents IconDirect Deposit of Salary Enrollment/Change FormAC2772
Hide details for Diversity FellowsDiversity Fellows
Multiple documents IconPost-Event Assessment - Diversity FellowsHRSF0048
Multiple documents IconUse of Diversity Fellow Participation at Event - Guide and ChecklistHRSF0047
Hide details for Employee DiscountsEmployee Discounts
Multiple documents IconSprint DiscountHRSD0052
Multiple documents IconStony Brook NYSC employee discounts flyerHRSD0108
Hide details for Employee Records and VerificationsEmployee Records and Verifications
Multiple documents IconOffice of the State Comptroller Personal Privacy Protection Law Release FormAC3216,AC3216i
Multiple documents IconRequest for Verification LetterHRSF0018
Multiple documents IconReview of Personnel File Request FormFILEREV
Hide details for Employment ApplicationsEmployment Applications
Multiple documents IconEmployment Application - All State Faculty PositionsHRSF0113
Multiple documents IconEmployment Application - All State PositionsHRSF0027,HRSF0027B,HRSF0027C
Multiple documents IconVoluntary Affirmative Action Information Survey (VAAIS) - All State PositionsODAA0001
Hide details for Extra ServiceExtra Service
Multiple documents IconDual Employment/Extra Service Approval FormAC1588
Multiple documents IconExtra Service and Dual Employment Compensation Policy and ProceduresHRSD0034
Multiple documents IconExtra Service Payroll VoucherAC873
Multiple documents IconMatrix of Required Extra Service FormsHRSD0023
Multiple documents IconRequest for Approval of Extra Service for M/C EmployeeUP6
Multiple documents IconRequest for Approval of Extra Service for UUP (BU-08) EmployeeUP8
Hide details for Fast FactsFast Facts
Multiple documents IconHRS Fast FactsHRSD0115,HRSD0115D,HRSD0115C,HRSD0115B,HRSD0115A
Hide details for Income TaxIncome Tax
Multiple documents IconDuplicate Tax Statement RequestSUSB0282S
Multiple documents IconFederal
Multiple documents IconNew York State
Multiple documents IconNYS Tax Return 414(h) Contributions ReminderHRSD0045
Hide details for Independent ContractorIndependent Contractor
Multiple documents IconCert of Acad Activity B1, B2, Wb, WT Visa-SBF.RF.STATEHRSF0050
Multiple documents IconCert of Academic Activity ABROAD - B1, B2, Wb, WT visaHRSF0053
Multiple documents IconForm 8233 - Exemption From Withholding on Compensation
for Independent (and Certain Dependent) Personal
Services of a Nonresident Alien Individual		8233
Multiple documents IconIndependent Contractor Service Form/Non-Employee Payment FormHRSF0005
Multiple documents IconIndependent Contractor Tax TreatyHRSD0109
Multiple documents IconIRS 20 Factors of the Common Law TestHRSF0044
Multiple documents IconNON-EMPLOYEE PAYMENT - Document ChecklistHRSD0014
Multiple documents IconW-7 Application for IRS Individual Taxpayer Identification NumberHRSF0108,HRSF0108i
Multiple documents IconW-8 BEN Certificate of Foreign Status of Beneficial Owner
for United States Tax Withholding		HRSF0110
Multiple documents IconW-9 Request for Taxpayer Identification Number and CertificationHRSF0111
Hide details for Job DescriptionsJob Descriptions
Multiple documents IconApplication for Change in Title or SalaryCC-2
Multiple documents IconPosition Description: Classified JobsCC-1
Multiple documents IconSecretary Questionnaire (NYS Department of Civil Service)HRSF0045
Hide details for PayrollPayroll
Multiple documents IconLost Paycheck FormHRSF0039
Multiple documents IconRecord of Authorized Signatures - Payroll Check Distribution OnlyHRSF0023
Hide details for Performance Programs and EvaluationsPerformance Programs and Evaluations
Multiple documents IconClassified Performance Evaluation Program (Professional, Scientific and Technical Service Unit)HRSF0014
Multiple documents IconPerformance Evaluation: Non-Teaching ProfessionalsHRSF0041
Multiple documents IconPerformance Program and Evaluation Compliance Matrix (UUP)HRSD0017
Multiple documents IconPerformance Programs and Evaluation Tool TutorialHRSD0075
Multiple documents IconPerformance Program: Non-Teaching ProfessionalsHRSF0040
Multiple documents IconProcess Overview: Employee Performance Program and Evaluation Process for UUP PSNUHRSD0018
Multiple documents IconState Classified Performance Evaluation Program (CSEA - B.U. 02, 03, 04)HRSF0013
Hide details for PublicationPublication
Multiple documents IconQuestions about Domestic ViolenceHRSD0079
Multiple documents IconResponding to Student Disruptions on CampusHRSD0057
Hide details for RecruitmentRecruitment
Multiple documents IconAuthorization to Obtain Pre-Employment Background Information - StateHRSF0080
Multiple documents IconEARN Approval Request - West Campus/HSC and All Research FoundationHRSF0025
Multiple documents IconExit Interview QuestionnaireHRSF0081
Multiple documents IconGuidelines for AdvertisingHRSD0085
Multiple documents IconPersonnel Requisition (West Campus/HSC & All RF)SUSB0037,SUSB0037A
Multiple documents IconPostdoc Ad - Science - Personnel Requisition & DescriptionHRSF0064
Multiple documents IconPre-Employment InquiriesHRSD0010
Multiple documents IconRecruitment for New and Replacement Professional PositionsHRSD0011
Multiple documents IconRecruitment for New and Replacement State Classified Support PositionsHRSD0070
Multiple documents IconRequest for Waiver of Recruitment (Search) or PromotionSUSB0654
Multiple documents IconRequest to Initiate Faculty Recruitment (Information for Faculty Posting)HRSF0085
Multiple documents IconResume Screening FormHRSF0094
Multiple documents IconSample SearchHRSD0069
Multiple documents IconSearch and Selection GuideHRSD0086
Multiple documents IconSummary of Affimative Action Recruitment Activities for Classified PositionsSUSB0068D
Multiple documents IconSummary of Affirmative Action Recruitment Activities for Faculty and Non-Teaching Professional PositionsSUSB0068
Multiple documents IconTemporary Agency Staffing Request - All FundsHRSF0024
Hide details for SampleSample
Multiple documents IconSample - Letter of Visitor RestrictionHRSD0084
Hide details for Time & Attendance/LeavesTime & Attendance/Leaves
Multiple documents IconAccident Reporting System (ARS) ProceduresHRSD0001
Multiple documents IconAttendance and Leave Accrual Report - M/C & UUP FLSA Non-Exempt Employees (FLSA Non-Exempt Time Sheet)303NE
Multiple documents IconFMLA Leave Request FormHRSF0003
Multiple documents IconFMLA RightsHRSD0076
Multiple documents IconFMLA WH-380-E Certification of Healthcare Provider (For employee's own serious health condition)WH-380-E
Multiple documents IconFMLA WH-380-F Certification of Healthcare Provider (For employee's family member's health condition)WH-380-F
Multiple documents IconFMLA WH-384 Certification of Qualifying ExigencyWH-384
Multiple documents IconFMLA WH-385 Certification for Serious Injury or Illness of Covered ServicememberWH-385
Multiple documents IconGraduate Student Employee Attendance ReportSUSB0381
Multiple documents IconLeave Donation Program - Classified Employee Recipient ApplicationHRSF0037
Multiple documents IconLeave Donation Program - DonorHRSF0038
Multiple documents IconLeave Donation Program - Professional Employee Recipient ApplicationHRSF0036
Multiple documents IconMedical Leaves Request FormHRSF0112
Multiple documents IconProfessional Staff Individual Report of AttendanceSUSB0303
Multiple documents IconTime & Attendance Guidelines - State Classified EmployeesHRSD0021
Multiple documents IconTime & Attendance Guidelines - State Professional & Faculty EmployeesHRSD0022
Multiple documents IconUniversity Leaves for Childcare, Child Birth, Adoption - State Classified EmployeesHRSD0004
Multiple documents IconUniversity Leaves for Childcare, Child Birth, Adoption - State Professional & Faculty EmployeesHRSD0002
Multiple documents IconWaiver of Additional Money for Holidays WorkedHRSF0021
Multiple documents IconWorkers' Compensation ProcedureHRSD0024
Multiple documents IconWorkers' Compensation/State Employee Injury/Illness Incident ReportSUSB3019
Hide details for Training & Organizational DevelopmentTraining & Organizational Development
Multiple documents Icon2012 NYS & CSEA Skills for Success Course CatalogHRSD0110
Multiple documents IconCustomized Training Request FormHRSF0087
Multiple documents IconEmployee Acknowledgement and Compliance StatementHRSF0066
Multiple documents IconEvaluation of On-Line Orientation ProgramHRSF0077
Multiple documents IconNew Employee Orientation - Certification of Receipt for Policies and ProceduresHRSF0065
Multiple documents IconNew Employee Orientation Registration FormHRSF0089
Multiple documents IconProgram EvaluationHRSF0096
Multiple documents IconSkillPort 3.1 User GuideHRSD0007
Multiple documents IconSkillSoft Business, IT and Desktop Skills TitlesHRSD0025,HRSD0025A,HRSD0025B,HRSD0025C
Multiple documents IconWorkplace Violence TrainingHRSD0106
Hide details for Volunteers (West Campus & HSC)Volunteers (West Campus & HSC)
Multiple documents IconState (non-faculty) & Research Foundation Volunteer GuidelinesHRSD0019
Multiple documents IconVolunteer Demographic Data FormHRSF0055

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