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Human Resources Forms

Work or Property Related Injury, Illness & Accommodation Forms

Employees (including student state workers injured on the job)

Students & Members of the Public

Voluntary Self-Identification of Disability


New Hire Forms

New Adjunct Information Form Please create an Initial Appointment Form in Interview Exchange

Business Card Request

Beneficiary Forms 

CSEA Accidental Death (log in with your CSEA ID)

UUP Life

MC Life


Employee Retirement System

Police and Fire Retirement System

Teachers Retirement System

NYS Deferred Compensation


Child Protection

SUNY Delhi's Child Protection Policy

SUNY's Mandatory Reporting Policy

SUNY Delhi Procedure

SUNY's Decision Tree

Key Contact Information

Child Protection Policy Acknowledgment Form

Application Form for Events Involving Children Under Age 17

Child Protection Policies training now available in Vancko Hall!
Moodle Powered LogoClick here to launch the training
             1. sign into Vancko Hall
             2. in the upper right corner, type into the search bar Child Protection, search  
             3. click on the course SUNY Delhi Child Protection Policies Training
             4. click Enroll Me
             5. begin the course by clicking Start Here 
Have a large group that needs training?
Contact Glenda Roberts at 607-746-4548 or via email at


Evaluation, Performance Program and Annual Report Forms

Classified Service Supervisor's Probationary Report

CSEA Evaluation for 2016-2017 

CSEA Performance Program for 2017-2018

Faculty Annual Report and Performance Program

Professional Employees' Evaluation Report

Professional Employees' Performance Program

Security Employees' Performance Program and Evaluation


Dental & Vision Claim, Student Verification Forms


GHI Dental Claim

Davis Vision Claim

Student Verification


Delta Dental Claim

Davis Vision Claim

Student Verification


Dental Claim

Vision Claim

Student Verification


Health Insurance & Related Program Forms

Empire Plan Claim

All Flex Spending Reimbursement forms

Health Insurance Transaction Form

Domestic Partner Application for benefits


Address Change & Emergency Contact Information

Update your address and other personal information with HR

Add or remove emergency contacts

ERS - Employee Retirement System Address Change

TRS - Teachers' Retirement Address Change

TIAA-CREF address change (you will be prompted to log in)

PFRS - Police & Fire Retirement System Address Change

UUP Address Change

CSEA Address Change

PBA Address Change (you will be prompted to log in)


Leave Forms

Request for Medical Leave of Absence

Non-Medical Request for Leave of Absence 

Leave Donation Form 

Unclassified Staff Leave Report


Family Medical Leave Act (FMLA)

Employee Guide

Employee Info: FMLA Rights and Responsibilities Notice

Employee: FMLA Notice of Eligibility 

Human Resources: FMLA Approval/Disapproval

Employee/Dr: Employee’s Serious Illness 

Employee/Dr: Family Member’s Serious Illness 

Employee: Military Family Leave 

Employee: Military Family Member’s Injury 


Retirement Forms

New York State Employees' Retirement System (ERS)

New York State Teachers' Retirement System (TRS)


TIAA Special Transfer Services

VOYA/VALICA Redirect Funds from MetLife 

Salary Reduction Agreement


Student Employment Forms

College Work Study Request

Student Assistant Request

Student Employment Application

Work Study Evaluation Sheet 

Student Assistant Evaluation Sheet 

Request for Student Employment - Summer

Tax Withholding and Other Payroll Forms

Federal Tax Withholding Form W-4

New York State Tax Withholding Form IT-2104

New York State Tax Exempt Form IT-2104e

Direct Deposit

Holiday Waiver

US Employment Eligibility Verification I-9 Form with Instructions

I-9 list of Acceptable Documents for Employment

I-9 Instructions

Over40 Comp Time II Pilot Program Description

Over40 Comp Time II 2017-2018 Enrollment Form 


Tuition Assistance

Tuition Assistance Application

UUP Waiver Registration

Employee Mandatory Fee Waiver Request


UUP Individual Development Awards

Supplemental Information Form

Exit Process Forms

Responsibilities During Exit Process



Charge of Discrimination Form

Discrimination Complaint Procedure




Additional Info

About the Area
Campus Safety Report
Dual Career Assistance
Driver Approval Process
Ethics in State Government
GOER Online Courses
Mail Handling Protocols
Notary Public Officers
Resources and Organizations
Staff Development
SUNY's Human Resources Site
SUNY Policies of Board of Trustees
Supervisor's Guide to Counseling
Violence & Harassment Prevention

PDF Icon Faculty & Staff Handbook

Contact Info
P: 607-746-4495 
F: 607-746-4158



Last Updated: 6/14/17