HR Forms
Appointment Action Forms
Helpful Tips: this document explains how to fill and sign PDF forms electonically.
PR Assist
Adjunct Management System
Graduate Assistant Forms
Reasonable Accommodation Policy and Forms
- Reasonable Accommodations Policy
- Reasonable Accommodations Request Form
- Reasonable Accommodations – Health Care Provider Assessment Form
Multiple Position Policy and Forms
- Multiple Position Report Form For Full-Time Faculty
- Multiple Position Memo
- Multiple Position Reporting Form for Non-Teaching Instructional Staff
- External Employment Reporting Form(Classified Staff)
Fall 2024 Open Enrollment Annual Transfer Period for Plan year 2025
•Change Health Insurance plans or add or drop health insurance plan riders is 11/1/2024 through11/30/24 with an effective date on the first full pay period of January 2025.
•FSA programs: DeCAP, HCFSA and Buy-Out Waiver plans 09/23/2024 through 11/08/2024.
•Dependent Care Assistance (DeCAP): $500 minimum, $5,000 maximum
•Health Care Flexible Account (HCFSA): $260 minimum, $3,200 maximum
•CUNY Catastrophic Sick Leave Bank 11/1/2024 through 11/30/2024
- Flexible Spending Accounts Manual
- FSA Enrollment/Change Form
- DeCAP Claim Form
- HCFSA Claim Form
- MSC Health Benefits Buy-Out Waiver
- Catastrophic Sick Leave Bank Program Information
- Catastrophic Sick Leave Bank Program – Application to Donate Sick Leave
- Catastrophic Sick Leave Bank Program – Application to Receive Sick Leave
- Catastrophic Sick Leave Bank Program – Application to Change Donation or Withdraw
- City of New York Health Benefits Application
- PSC Enrollment Form
- PSC Change of Status From
Benefits Forms
- My Benefits at a Glance Form
- Tuition Waiver Request Form
- CUNY Employee Tuition Waiver Form
- Welfare Fund Enrollment Form
- Flexible Spending Accounts Enrollment/Change Form
- Health Benefits Buy-Out Waiver Form
- CCA@YourService Employee Assistance Program
- Domestic Partnership Registration for Bereavement Leave
- FFCRA (Families First Coronavirus Response Act)
- Family Medical Leave Act (FMLA) Policy and Information
- Family Medical Leave Act (FMLA) Policy
- Notice of Eligibility and Rights and Responsibilities
- FMLA Request Form
- Designation Notice
- Fitness for Duty Certification
- Certification of Family Relationship Form
- Certification of Health Care Provider (HCP) for Employee's Serious Health Condition
- Certification of Health Care Provider (HCP) for Family Member's Serious Health Condition
- Certification for Serious Injury or Illness of a Current Service Member - Military Family Leave
- Certification for Serious Injury or Illness of a Veteran - Military Caregiver Leave
- Certification of Qualifying Exigency for Military Family Leave
- Non-FMLA Medical Leave Forms
- Fellowship Leave Application
- Paid Parental Leave
- Paid Parental Leave Information
- Paid Parental Leave Application Form
- Paid Parental Leave Policy
- Revised Paid Parental Leave Policy Memo
- Unpaid Child Care Leave Form
- Paid Family Leave Guidelines for PSC
- SC-PFL-Bonding Application
- SC-PFL-Care For Family Application
- SC-PFL-Military Application
- General Employment Application
- Instructions for the Addition of Domestic Partners to City Health Plan Coverage
- Professional Development Funds Application (HEO & CLT Title series)
- Special Leave of Absence Without Pay
- Partial Leave With Partial Pay
- Special Leave for Child Care (Unpaid) Application
- CUNY Phased Retirement Professional Staff Application
- CUNY Phased Retirement Faculty Application
- Retirement Leave of Absence (Instructional Staff)
- Scholar Incentive Award Application
- Aetna Medical Claim Form
- TRS Certification of Employment Under Section 212 / IA8 Form
- Certification of Employment Under Section 212 for Members of the Optional Retirement Program
- Dental Claim Form (DC 37)
- Dental Claim Form: Guardian (PSC-CUNY)
- Dental Enrollment Form: Delta Dental (PSC-CUNY)
- Dental Transfer Form: Delta Dental (PSC-CUNY)
- GHI Health Insurance Claim Form HCFA-1500
- New Employee HIP HMO Opt-Out Request Form
- Long-Term Disability Benefits Claim Packet (Instructional Staff)
- PSC-CUNY Welfare Fund Optical Reimbursement Form
- Retiree Change of Address Form
- Short-term Disability Benefit Claim Form (DC 37)
- TIAA-CREF Contributions on Multiple Positions Form
- NYS Young Adult Coverage Age 29 Forms
- CUNY Dedicated Sick Leave Policy
- Application to Dedicated Leave
- Application to Receive Dedicated Leave
- HEO CLT Application and Guidelines (Professional Development)
- Classified Staff Agency Shope Fee Authorization Form
- PSC Agency Shop Fee Authorization Form
- Bargaining Unit Exclusion Form for Instructional Staff
- DC37 Union Membership Form
Transit Forms
- Edenred Transit Benefit Plan Application(City)
- Edenred Transit Benefit Plan Application(State)
- Edenred Park-N-Ride Plans Form(City)
- Edenred Park-N-Ride Plans Form(State)
Workers' Compensation Forms
- DP-2002 - Employee Selection of Option
- WCD-201 - Supervisor's Report of an Injury/Illness
- WCD-23 -Employee Statement of Accident
- WCD-26 - Witness Reporting of Injury
Employement Verification Forms
Exempt and Non-Exempt Time Sheets
- Exempt Timesheet
- Non-Exempt Timesheet
- Overtime Payment Request (Exempt)
- Overtime Payment Request (Non-Exempt)
- HEO Compensatory Time Agreement
Payroll Forms
- Adjunct Timesheets
- Advance Earned Income Tax Credit
- Direct Deposit of Salary Enrollment Form (State Payroll)
- Direct Deposit of Salary Enrollment Form (City Payroll)
- Form 8233 (Non Resident Alien Tax Exemption Form)
- Form W-4 ( Federal Tax Withholding Form)
- IT-2104 (Employee's Withholding Allowance Certificate)
- IT-2104 E (Certificate of Exemption from Withholding)
- Time Attendance Report
Performance Management Forms
- Classified Managerial Performance Evaluation (Managerial)
- Classified Employee Performance Evaluation (Non managerial)
(PDF format) (Word format) - HEO Performance Evaluation Memorandum (PDF format)
(Word format) 
*** Forms updated as of Jan-2011 (for Word format, save the file to your computer and edit from Word not Internet Explorer.) - CLT Evaluation Memorandum Form
- (PDF format) (Word format)
- CLT Evaluation Instructions
- Campus Peace Officer Performance Appraisal
HEO Labor Management
Miscellaneous
- Approved Foreign Education Evaluation Services
- Authorization for Release of Information
- Budget Authorization Form
- Application form for Library Reassignment Leaves
- Change of Address
- Classified Service Merit Guidelines (Managerial)
- Classified Service Merit Guidelines (Non-managerial)
- E-Mail Account Request Form (from Hunter ICIT Web Site)
- Emergency Evacuation Form
- Employee Preferred Name Change Request Form
- Employee Request for Name and Gender Changes Memo
- Employee Request for Gender Change Request Form
- Gittleson Intra-College Transfer
- History of Service
- Honoraria Memo to Faculty & Staff
- Honoraria Reporting Filing Guidelines
- Honoraria Reporting Form- Faculty
- Honoraria Reporting Form- Non Faculty
- Hourly Instructional Staff Report of Absences
- I-9 Form (Employee Eligibility Verification)
- IT Security Policy
- Managerial Uniform Allowance Application
- Non Tax Levy Role Assignment Form
- Non-Teaching Instructional Staff Action Form (HEO, CLT, RA Title Series Green Form)
- Request for Placement on Transfer Roster (Competitive Titles)
- Request for Placement on Transfer Roster (Non-Competitive Titles)
- Request for Placement on Transfer Roster. (Skilled Trade Titles)
- Request for Reinstatement
- 2017 Prepaid Legal Services Benefit - District Council 37
- Person of Interest (POI) Data Form
- Person of Interest (POI) Renewal Form