HR Forms

Benefits and Wellness

Access-A-Ride/Para Transit Enrollment Form

Application for Leave for Special Purposes: Instructional Staff (Teaching and Non-Teaching) Only

Application for Non-FMLA Medical Leave

Catastrophic Sick Leave- Application to Donate

Catastrophic Sick Leave- Application to Receive

Catastrophic Sick Leave- Application to Withdraw and/or Change Donation

Catastrophic Sick Leave Bank Program Information

Change of Address Benefits Form

Child Care Leave of Absence Application (Unpaid) – Classified Staff Only

Child Care Leave of Absence Application (Unpaid) – Instructional Staff Only

CUNY Universal Annual Notice TDA Letter - TIAA

CVS Caremark Mail Order Form

Davis Vision Claim Form

DC37 Change of Status Form

DC37 Dental Claim

DC37 Enrollment

Dedicated Sick Leave- Application to Donate

Dedicated Sick Leave- Application to Receive

Dedicated Sick Leave Program

Dependent Care Assistant Program (DeCAP) form

Domestic Partner, Same Sex Marriage or Civil Union- Information Packet

Emergency Family Medical Leave Expansion Act Attestation and Request Form

Emergency Paid Sick Leave Attestation and Request Form

Family Medical Leave Act (FMLA) - Process Flowchart

Family Medical Leave Act (FMLA) - Presentation

Family Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Current Service Member – Military Family Leave

Family Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Veteran – Military Caregiver Leave

Family Medical Leave Act (FMLA) Certification of Family Relationship

Family Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Employee

Family Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Family Member

Family Medical Leave Act (FMLA) Certification of Qualifying Exigency for Military Family

Family Medical Leave Act (FMLA) Designation Notice

Family Medical Leave Act (FMLA) Fitness for Duty

Family Medical Leave Act (FMLA) Notice of Eligibility and Rights and Responsibilities

Family Medical Leave Act (FMLA) Policy

Family Medical Leave Act (FMLA) Request Form

Family Medical Leave Act Employee Guide

FSA Brochure

Health Benefits Application

Health Benefits Buy-Out Waiver Application

Health Benefits Rate Sheet

Healthcare Flexible Spending Account (HCFSA) form

Leave for Breast and Prostate Cancer Screening and for Blood Donation

Military Leave

New York City Employees’ Retirement System Enrollment

New York City Health Benefits Program

New York City Teachers’ Retirement System Designation of QPP Beneficiary

New York City Teachers’ Retirement System Enrollment

New York State Deferred Compensation 457 Plan

New York’s College Savings Program 529

Non-FMLA Fitness for Duty Certification

Non-FMLA Medical Leave Designation Form

NY529 Enrollment

NYS Deferred Comp Enrollment Form

NYS Deferred Comp Enrollment Kit

NYSHIP Application to Add Domestic Partner to Coverage

NYSHIP Change of Address

NYSHIP Enrollment

NYSHIP Termination

NYSHIP Termination of Domestic Partnership

NYSHIP Transfer

NYSUT Payroll Deduction Card

Paid Family Leave (PFL)

Paid Parental Leave Application - Amended

Paid Parental Leave Cover Page

Paid Parental Leave Policy Update

Park-N-Ride Enrollment Form

Phased Retirement Application for Faculty

Phased Retirement Application for Professional Staff

Phased Retirement Program

Premium Conversion Form

Prescription Drug Exemption Request Form

PSC Welfare Fund Change of Status

PSC/CUNY Application for Welfare Fund Benefits for Domestic Partner

PSC/CUNY Death Benefit Designation

PSC/CUNY Delta Dental Claim

PSC/CUNY Enrollment

PSC/CUNY Extended Medical Benefit Claim Form – For Employees with GHI

PSC/CUNY Guardian Non-Participating Dental Claim

PSC/CUNY Hearing Aid Reimbursement

PSC/CUNY Retiree Enrollment

Reasonable Accommodation Form - Employee

Reasonable Accommodation Form - Health Care Provider

Retiree Application

Retiree Change of Address

Retiree Email Request Form

Retirement Election Form

Retirement Leave of Absence Request (TRAVIA)

Salary Reduction Agreement -TIAA-Cref

Tax Deferred Annuity Program

Terminal Leave Form

TIAA-CREF Medicare Part B Premium Reimbursement

TIAA-CREF Multiple Positions

TIAA-CREF Optional Retirement Program – Online Enrollment

TIAA-CREF Supplemental Retirement Annuity – Online Enrollment

Transit Benefit Enrollment Form

Travia Leave Packet

TRS Benefits For Tier IV Members

TRS Benefits For Tier VI Members

Tuition Fee Waiver

Tuition Waiver Addendum

Worker’s Compensation Claim Forms

Employment Services & Talent Acquisition

Adjunct Faculty Position Request Form

Appendix A to C- Performance Evaluation Form for Classified Employees

Classified Evaluation Form

Classified External Employment Approval Form

Classified Managerial – Performance Accountability Assessment

Classified Reinstatement Request Form

College Assistant Position Request Form

CUNY Workload Reporting Form

Electronic Human Resources Action Form

Excluded HEO Staff Evaluation Form

Executive Compensation Plan (ECP) Evaluation Instructions

Executive Compensation Plan (ECP) Evaluation Form

Full-Time Position Request Form

HEO & Classified Staff Committee Action Request Form (You must download and save the form to use the electronic signature feature)

HEO & Classified Staff Committees Memo

HEO Evaluation Form

HEO Evaluation Form – esign (You must download and save the form to use the electronic signature feature)

HEO Labor Management Committee Assignment Differential Application

HEO Labor Management Committee Work Load

HEO Reclassification Form

Inter-CUNY Transfer Request Form- For Classified Staff

Multiple Position Form for Non-Teaching Instructional Staff - Application

Multiple Position Form for Non-Teaching Instructional Staff – Memo

Public Safety Performance Appraisal

Remote Work Agreement Form

Salary Differential Request

Human Resources Information Systems

Change of Address

Data Report Request Form

Employee ID Lookup

Employee Self Service/Claim Your CUNYFirst Account

Employee Self Service - Public Service Loan Forgiveness in CUNYFirst

Gender Change Request Form

How to use and navigate Peoplesoft 9.2

Person of Interest Form

Preferred Name Request Form

Payroll and Time & Leave

Adjunct Workload Reporting Form

CET-Continuing Education Teacher

College Assistant/Hourly/Student Aide - Pending

College Lab Tech - Adjunct - Pending

CUNY Employee Holiday and Annual Leave 2024-2025

Direct Deposit Addendum

Direct Deposit Form

Etime

FT Classified - White Collar (COA, IT, etc. - Pending

FT Classified- Blue Collar (Facilities, Public Safety) - Pending

FT Classified- Blue Collar (Skilled Trades Only) - Pending

HEO CT/OT Form

IT2104-City and State Certificate of Tax Withholding

Mail Authorization/Check Reissue Request

Non-Teaching (AJC) Timesheet

Payroll Calendar - ECP

Payroll Calendar - Full Time Employees

Submission Schedule- FT

Submission Schedule- PT

Teaching Adjunct Pay Check Schedule - Summer 2024

Teaching Adjunct Pay Check Schedule - Fall 2024, Winter 2025, Spring 2025

Vacation Request Form Classified Titles

W4- Federal Tax form

HR Forms

Benefits and Wellness

Employment Services & Talent Acquisition

Human Resources Information Systems

Payroll and Time & Leave

Undergraduate Admissions

Graduate Admissions