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Human Resources Forms

How do I...

1. Change my address and/or personal information?

Personal Information Self-Service Online Link* 

*Use this link to update your address, legal name and view your paycheck.  If any other information needs updating such as name, degree, emergency contacts, etc., please print the Personal Information form and send to Human Resources & Payroll Services, Doty Hall 318. For further instructions, view this helpful powerpoint: Instructions for Accessing Self-Service Link

Additionally, when you change your address -- remember you will need to contact any union sponsored benefits that you may have (dental, vision, life insurance, etc.) and your retirement carriers including any tax-deferred annuity providers you may have.  PRINT THIS ADDRESS CHANGE LIST DOCUMENT FOR CONTACT INFORMATION.

2.  Add a newborn to my health insurance coverage?

To add a newborn baby to your health insurance, you'll need to complete the NYS Health Insurance Transaction Form (PS 404) which is found in the benefits section of this HR Forms page. Complete Nos. 1-9, add the newborn baby's name and date of birth in No. 13, then sign and date. Once you receive the baby's birth certificate and social security card, you will need to send copies of each to Victoria Phipps (phipps@geneseo.edu).

3. Contact your Health Benefits Administrator (Victoria Phipps)?

Contact your HBA within 7 days of life-changing events to best avoid delays in coverage and retro charges in your paycheck! Examples of life-changing events are:

  • change in marital status;
  • the birth of a baby;
  • change of address;
  • going on a leave without pay;
  • retirement;
  • check out the full list HERE

You will need to complete the NYS Health Insurance Transaction PS 404 Form. Additional documentation may be required. Contact Victoria at phipps@geneseo.edu or 585-245-5616.

 

New Faculty or Staff Employee Required Forms Packet
New Student Employee Required Forms Packet

 

Student Forms

Federal Work Study Award Tracker for Students & Supervisors

Federal Work Study Time Record

Graduate Student Employee Attendance

Information for Students

Student Employee Orientation Checklist

Student Employee Retirement Option

Student Employment Forms Guideline

Student Employment Supervisor Handbook

Student Online Timesheet Instructions

Temp Service Appointment Form

Faculty & Staff Forms

Accident Report

Alternative Work Location Agreement

Applicant Release for Background Investigation

Cancer Screening Leave

Classified Staff Holiday Certification (GP-8)

Classified Time and Accrual Worksheet

CSEA Annual Performance Evaluation

CSEA Dental and Vision Online Enrollment

CSEA Monthly Evaluation Form

Direct Deposit (Guide to Completing Direct Deposit Form)

Direct Deposit Reactivation Request

Domestic Partner Dependent Tax Affidavit for Enrollment in NYSHIP, PS-425.3

Domestic Partner Enrollment Application & Instructions, PS-425

Domestic Partner Termination Form, PS-425.4

Employee Information Form

Employee On-The-Job Accident and Injury Report

Employees' Retirement System Application for Membership

Estimated Physical Capabilities

Extra Service Form/Extra Service Matrix

Federal Tax W-4 (IRS Tax Withholding Estimator)

FMLA Essential Responsibilities

FMLA Leave Request

FMLA Leave Request - Adoption Placement

Form I-9, Employment Eligibility Verification (Docusign Version)

DocuSign Form I-9 Instructions: You will need to choose an "authorized representative" to view your documents and complete page 2 of this form for you. You will need to provide their name and email in the DocuSign Form I-9. You can designate a friend, family member, supervisor, etc. to be your authorized representative. Additional documentation is required. On the first page, you will complete your employee information, electronically sign and date. On page 2, you will need to present unexpired, original documentation that shows proof of identity and work authorization to your authorized representative. Please see page 3 of the Form I-9 for the acceptable documents showing proof. You can present one document from List A OR a combination of documents from List B and C. You will need to upload your proof of identity and work authorization documents into this DocuSign I-9 form. 

Geneseo Employment Recommendation Form (GER)

Geneseo Pride Nomination

Graduate Assistant/Teaching Assistant Attendance Report Form

Holiday Waiver (Classified Service Only)

Honoraria

Hourly Employee Biweekly Time Sheet

Human Resources Data Request

Human Resources Label Request

Independent Contractor - Checklist for Determining Workers Status

Independent Contractor - Guide to Determining Workers Status

Intent to Retire Form Letter (Classified Service Staff)

Intent to Retire Form Letter (Professional Staff & Faculty) 

Internal Career Advancement Request Form

Invitation for Self-Identify for Veterans

Job Description Questionnaire

Manage SUNY Tax-Deferred Annuity - SUNY Retirement@Work

M/C Dental/Vision Student Verification Form

M/C Performance Appraisal (NU-06)

M/C Performance Evaluation

M/C Performance Program

NYS Paid Family Leave

NYS Paid Family Leave Forms

NYS Paid Family Leave Statement of Rights

NYS Tax Withholding IT-2104

NYSHIP Health Insurance Transaction Form (PS-404)

NYSHIP Opt Out Attestation Form (PS-409)

NYSHIP Sick Leave Credit Option Election Form (PS-405)

Oath of Office Statement

Official Activity Expense Payment

Outside Activity for Policy Makers Only Only (if over $5,000)

Overtime Authorization

Performance Evaluation Form for UP 01

Performance Evaluation Form for UP 02

Performance Evaluation Program Form - PEF 

Police and Fire Membership Application, PF 5022

Productivity Enhancement Program - Classified Service Employees

Productivity Enhancement Program - MC Professional Employees

Productivity Enhancement Program - UUP Professional Employees

Professional Evaluation

Professional Performance Program

Professional Review Request

Professional Secondary Source

Professional Self-Assessment

Professional Staff Request for Review of Salary Increase or Promotion

Reasonable Accommodation Request

Request for Approval of Extra Service - MC Employee (UP6)

Request for Approval of Extra Service - UUP Employee (UP8)

Request for Approval of Professional Appointment - Continuing, Permanent (UP3)

Request for Reclassification of Classified Position

Request to View Personnel File

Retirement Election - Retirement@Work

Retirement Election Form for Optional Employees

Return to Work Form

Separation Sign-off Form

Staffing Plan Support Documentation Form

Teachers' Retirement System Application for Membership

Tenure Clock Stoppage Form

Title F Leave Application 

Tuition Waiver B-140W

UUP Change of Address Form

UUP Change of Marital or Dependent Status Form

UUP DHMO Enrollment Form

UUP Group Life Insurance Form

UUP & MC Active Military Leave Forms

UUP & MC Bonding Leave Packet

UUP & MC Family Care Leave Forms

UUP Tuition Waiver Application

Visitor COVID Screening Questionnaire 

Voluntary Reduction in Work Schedule Application (VRWS)

Voluntary Reduction in Work Schedule Guidelines

Voluntary Self-Identification of Disability

Volunteer Application

W-2 Reprint Request

Waiver of Recruitment

WH-380E: Certification of Health Care Provider for Employee's Serious Health Condition

WH-380F: Certification of Health Care Provider for Family Member's Serious Health Condition

WH-384: Certification of Qualifying Exigency for Military Family Leave

WH-385: Certification of Serious Injury or Illness of Covered Service Member- for Military Family Leave