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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 employees need to complete an electronic forms packet via DocuSign before or on their first day of employment.

If you are a classified service employee (Cleaner, Plant Utilities Assistant, Office Assistant, Administrative Assistant, etc.) please click the link below:

NEW Classified Service Employee

If you are faculty or professional staff (Adjunct Lecturer, Lecturer, Assistant Professor, Staff Assistant, Programmer Analyst, Dean, etc.) please click the link below:

NEW Faculty or Professional (Unclassified Service) Employee


Below are the instructions for completing these fillable, electronic DocuSign Forms. Please read very carefully. 

Welcome to Geneseo! Fill in the name and email for each signing role; the definitions of these roles are listed below. Signers will receive an email with instructions inviting them to sign this document as necessary. Then click on the yellow "Begin Signing" button.

Employee -- This would be you. Enter your name and email in this role.

Authorized Friend or Family Member -- Enter the person's name and email address that you choose to be your "authorized representative". Your authorized representative will view your I-9 documents and complete page 2 of this form for you. When you complete this form, it will ask you to attach and upload documents from either List A OR List B and C (found on page three of the I-9 form) The name and email that you entered as your authorized representative can be a friend, family member, supervisor, etc. On the first page, you will complete your employee information, electronically sign and date. On page 2, you will need to attach and upload unexpired, original documentation that shows proof of identity and work authorization to your authorized representative.  You can present one document from List A OR a combination of documents from List B and C.  The person you chose as your authorized representative will get an email to complete page 2 electronically. Your authorized representative MUST view the original documents that you present.

Joint Account Holder -- For your direct deposit form, if your checking or savings account has a joint account holder on your account, this person will also need to sign this direct deposit form. Enter the person's name and email as the joint account holder. This person will receive an email to electronically sign and date this form. 

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
Printable Form Docusign Form Online Form
Accident Report    
Alternate Work Location Agreement Information Alternative Work Location Agreement Form  
Applicant Release for Background Investigation 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    
Employment Eligibility Form I-9 (paper version) Form I-9, Employment Eligibility Verification *(DocuSign Version)  
Geneseo Employment Recommendation Form    
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 Forms    
NYS Withholding Form IT-2104 NYS Tax Withholding IT-2104  
NYSHIP Health Insurance Transaction Form (PS-404) NYSHIP Health Insurance Transaction Form (PS404)  
NYSHIP Opt-Out Attestation Form (PS-409)    

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

   
Oath of Office Statement 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 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 Enrollment Form (Dental/Vision)
    UUP Change of Marital or Dependent Status Form
    UUP Enrollment Form (Dental/Vision)
    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    
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    

*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.