HR Forms

Access-A-Ride/Para Transit Enrollment Form
Application for Leave for Special Purposes: Instructional Staff (Teaching and Non-Teaching) Only
Application for Non-FMLA Medical Leave 
Catastrophic Sick Leave- Application to Donate
Catastrophic Sick Leave- Application to Receive 
Catastrophic Sick Leave- Application to Withdraw and/or Change Donation
Catastrophic Sick Leave Bank Program Information
Change of Address Benefits Form
Child Care Leave of Absence Application (Unpaid) – Classified Staff Only
Child Care Leave of Absence Application (Unpaid) – Instructional Staff Only
CUNY Universal Annual Notice TDA Letter - TIAA
CVS Caremark Mail Order Form
Davis Vision Claim Form
DC37 Change of Status Form
DC37 Dental Claim
DC37 Enrollment 
Dedicated Sick Leave- Application to Donate
Dedicated Sick Leave- Application to Receive
Dedicated Sick Leave Program
Dependent Care Assistant Program (DeCAP) form
Domestic Partner, Same Sex Marriage or Civil Union- Information Packet
Emergency Family Medical Leave Expansion Act Attestation and Request Form
Emergency Paid Sick Leave Attestation and Request Form
Family Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Current Service Member – Military Family Leave
Family Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Veteran – Military Caregiver Leave
Family Medical Leave Act (FMLA) Certification of Family Relationship 
Family Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Employee
Family Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Family Member
Family Medical Leave Act (FMLA) Certification of Qualifying Exigency for Military Family
Family Medical Leave Act (FMLA) Designation Notice
Family Medical Leave Act (FMLA) Fitness for Duty
Family Medical Leave Act (FMLA) Notice of Eligibility and Rights and Responsibilities
Family Medical Leave Act (FMLA) Policy 
Family Medical Leave Act (FMLA) Request Form 
Family Medical Leave Act Employee Guide
FSA Brochure
Health Benefits Application
Health Benefits Buy-Out Waiver Application
Health Benefits Rate Sheet
Healthcare Flexible Spending Account (HCFSA) form
Leave for Breast and Prostate Cancer Screening and for Blood Donation
Military Leave
New York City Employees’ Retirement System Enrollment 
New York City Health Benefits Program
New York City Teachers’ Retirement System Designation of QPP Beneficiary
New York City Teachers’ Retirement System Enrollment
New York State Deferred Compensation 457 Plan
New York’s College Savings Program 529
Non-FMLA Fitness for Duty Certification
Non-FMLA Medical Leave Designation Form
NY529 Enrollment
NYS Deferred Comp Enrollment Form
NYS Deferred Comp Enrollment Kit
NYSHIP Application to Add Domestic Partner to Coverage
NYSHIP Change of Address
NYSHIP Enrollment
NYSHIP Termination
NYSHIP Termination of Domestic Partnership
NYSHIP Transfer
NYSUT Payroll Deduction Card
Paid Family Leave (PFL)
Paid Parental Leave Application - Amended
Paid Parental Leave Cover Page
Paid Parental Leave Policy Update
Park-N-Ride Enrollment Form
Phased Retirement Application for Faculty
Phased Retirement Application for Professional Staff
Phased Retirement Program
Premium Conversion Form
Prescription Drug Exemption Request Form
PSC Welfare Fund Change of Status
PSC/CUNY Application for Welfare Fund Benefits for Domestic Partner
PSC/CUNY Death Benefit Designation
PSC/CUNY Delta Dental Claim
PSC/CUNY Enrollment
PSC/CUNY Extended Medical Benefit Claim Form – For Employees with GHI
PSC/CUNY Guardian Non-Participating Dental Claim
PSC/CUNY Hearing Aid Reimbursement
PSC/CUNY Retiree Enrollment
Reasonable Accommodation Form - Employee
Reasonable Accommodation Form - Health Care Provider
Retiree Application
Retiree Change of Address
Retiree Email Request Form
Retirement Election Form
Retirement Leave of Absence Request (TRAVIA)
Salary Reduction Agreement -TIAA-Cref
Tax Deferred Annuity Program
Terminal Leave Form
TIAA-CREF Medicare Part B Premium Reimbursement 
TIAA-CREF Multiple Positions
TIAA-CREF Optional Retirement Program – Online Enrollment
TIAA-CREF Supplemental Retirement Annuity – Online Enrollment
Transit Benefit Enrollment Form
Travia Leave Packet
TRS Benefits For Tier IV Members
TRS Benefits For Tier VI Members
Tuition Fee Waiver
Tuition Waiver Addendum
Worker’s Compensation Claim Forms