Human Resources Forms


FLSA Questionnaire Professional Staff

Job Description Questionnaire

Independent Contractor - Checklist for Determining Workers Status

Independent Contractor - Guide to Determining Workers Status

Request for Reclassification of Classified Position

Recruitment & Selection

Background Investigation Release

Facilities Services Application for Employment

Invitation for Self-Identify for Veterans

Offer Summary for New Faculty Appointment

Offer Summary for New Professional Appointment

Offer Summary for New M/C Appointment

Vacancy Announcement (Classified Service)

Vacancy Announcement Facilities Services (Classified Service)

Voluntary Self-Identification of Disablity

Waiver of Recruitment


Personal Information Self-Service Online Link* 

*NOTE: THIS SELF-SERVICE PROCESS REPLACES THE DIRECTORY CHANGE FORM. Use this link to update your address 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

Confidentiality Statement

Dual Employment & Extra Service Approval (AC-1588)

Employee Information Form for New Employees

Extra Service Form/Extra Service Matrix

Form I-9, Employment Eligibility Verification

Geneseo Employment Recommendation Form (GER)

Oath of Office Statement

Professional Staff Request for Review of Salary Increase or Promotion

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, Sabbatical (UP3)

Separation Sign-Off

Title F Leave Application

Volunteer Application 


CSEA Change of Address Form

CSEA Dental/Vision Enrollment Form

CSEA Dental and Vision Online Enrollment

CSEA Membership Application Form

CSEA Student Verification Form

Employees' Retirement System Membership Registration Form

M/C Davis Vision Student Verification Form

M/C GHI Dental Student Verification Form

NYPERL Fact Sheet

NYS Health Insurance Transaction Form (PS-404)

ORP-4: ERS Determination

2016 Opt Out Attestation Form PS-409

Request for Coverage Under the Young Adult Option (YAD-NYPE)

Retirement Election Form (2 pages)

Teachers' Retirement System Application for Membership

UUP Benefit Fund Address Change Form

UUP Change in Dependent/Marital Status Form

UUP Dental/Vision Enrollment Form 

UUP Life Insurance Form

UUP Membership Application  -- UUP has created an e-membership card that prospective members can fill out online and send electronically to UUP—instantly making them a UUP member.  This application will not enroll you in the Dental/Vision Benefits.  See above for UUP Dental and Vision Enrollment Form.

UUP Student Verification Form 



Official Activity Expense Payment

Outside Activity for Policy Makers Only 

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


Employee On-The-Job Accident and Injury Report

Estimated Physical Capabilities

Estimated Physical Capabilities for Security Services and Supervisors

FMLA Essential Responsibilities

FMLA Leave Request

FMLA Leave Request - Adoption Placement

Return to Work Form

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 Servicemember- for Military Family Leave 


Direct Deposit

Direct Deposit Reactivation Request

Extra Service Payroll Voucher

I-9 Employment Eligibility Verification

Federal Tax W-4

NYS Tax Withholding IT-2104

Overtime Authorization

Salary Reduction Agreement (for TDA's & SRA's)

W-2 Reprint Request

Performance Management

Annual Performance Evaluation - CSEA

M/C Performance Program and Evaluation

M/C Performance Appraisal (NU-06)

Monthly Evaluation - Classified Staff

Professional Evaluation

Professional Performance Program

Professional Review Request

Professional Self-Evaluation

Performance Evaluation Program/Employee Worksheet Form - PEF

Performance Evaluation Program Form - PEF 

Time & Attendance

Breast Cancer Screening Leave

Classified Employee Biweekly Time Sheet

Classified Staff Holiday Certification (GP-8)

Classified Time and Accrual Worksheet

Professional Time and Accrual Worksheet (Monthly)

Full Time Faculty Attendance Cert.

Faculty Monthly Exception Report

Graduate Assistant/Teaching Assistant Attendance Report Form

Hourly Employee Biweekly Time Sheet

M/C & Professional Monthly Attendance Report

Professional Employee Time Sheet for Non-Exempt Staff

Prostate Cancer Screening Leave

Part-Time Faculty Attendance Cert.

Time Off Request

Voluntary Reduction in Work Schedule Application (VRWS)

Voluntary Reduction in Work Schedule Guidelines

Training & Development

Tuition Waiver B-140W

UUP Tuition Waiver Application 


Change of Address

Federal Work Study Time Record

Federal Work Study Award Tracker for Students & Supervisors

Graduate Student Employee Attendance

Information for Students

Student Employee Orientation Checklist

Student Employment Supervisor Handbook

Student Employee Retirement Option

Student Employment Forms Guideline

Temp Service Appointment Form

Temp Service Time Record 


Geneseo Pride Nomination

Human Resources Data Request

Human Resources Label Request

Reasonable Accommodation Request

Alternative Work Location Agreement for Professional Staff

Request to View Personnel File

Phased Retirement Eligibility Application for Faculty