HR Forms Breadcrumb Home About Senior Leadership Office of Finance & Administration Human Resources HR Forms Benefits and Wellness Application for Leave for Special Purposes: Instructional Staff (Teaching and Non-Teaching) OnlyApplication for Non-FMLA Medical Leave Catastrophic Sick Leave- Application to DonateCatastrophic Sick Leave- Application to Receive Catastrophic Sick Leave- Application to Withdraw and/or Change DonationCatastrophic Sick Leave Bank Program InformationChange of Address Benefits FormChild Care Leave of Absence Application (Unpaid) – Classified Staff OnlyChild Care Leave of Absence Application (Unpaid) – Instructional Staff OnlyCommuter Card - Access-A-Ride Plan (Transit)Commuter Card - Park-N-Ride Plan (Parking)Commuter Card - Prepaid Mastercard Plan (Transit)Commuter Card - Transit Pass Plan (Transit)CUNY Universal Annual Notice TDA Letter - TIAACVS Caremark Mail Order FormDavis Vision Claim FormDC37 Change of Status FormDC37 Dental ClaimDC37 Enrollment Dedicated Sick Leave- Application to DonateDedicated Sick Leave- Application to ReceiveDedicated Sick Leave ProgramDependent Care Assistant Program (DeCAP) formDomestic Partner, Same Sex Marriage or Civil Union- Information PacketEmergency Family Medical Leave Expansion Act Attestation and Request FormEmergency Paid Sick Leave Attestation and Request FormFamily Medical Leave Act (FMLA) - Process FlowchartFamily Medical Leave Act (FMLA) - PresentationFamily Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Current Service Member – Military Family LeaveFamily Medical Leave Act (FMLA) Certification for Serious Injury or Illness of a Veteran – Military Caregiver LeaveFamily Medical Leave Act (FMLA) Certification of Family Relationship Family Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for EmployeeFamily Medical Leave Act (FMLA) Certification of Health Care Provider (HCP) for Family MemberFamily Medical Leave Act (FMLA) Certification of Qualifying Exigency for Military FamilyFamily Medical Leave Act (FMLA) Designation NoticeFamily Medical Leave Act (FMLA) Fitness for DutyFamily Medical Leave Act (FMLA) Notice of Eligibility and Rights and ResponsibilitiesFamily Medical Leave Act (FMLA) Policy Family Medical Leave Act (FMLA) Request Form Family Medical Leave Act Employee GuideFSA BrochureFSA-HCFSA-DeCAP Change FormHealth Benefits ApplicationHealth Benefits Buy-Out Waiver ApplicationHealth Benefits Rate Sheet - AdjunctsHealth Benefits Rate Sheet - EmployeesHealth Benefits Rate Sheet - RetireesHealth Benefits - Young Adult PackageLeave for Breast and Prostate Cancer Screening and for Blood DonationMilitary LeaveNew York City Employees’ Retirement System Enrollment New York City Health Benefits ProgramNew York City Teachers’ Retirement System Designation of QPP BeneficiaryNew York City Teachers’ Retirement System EnrollmentNew York State Deferred Compensation 457 PlanNew York’s College Savings Program 529Non-FMLA Fitness for Duty CertificationNon-FMLA Medical Leave Designation FormNY529 EnrollmentNYS Deferred Comp Enrollment FormNYS Deferred Comp Enrollment KitNYSHIP Application to Add Domestic Partner to CoverageNYSHIP Change of AddressNYSHIP EnrollmentNYSHIP TerminationNYSHIP Termination of Domestic PartnershipNYSHIP TransferNYSUT Payroll Deduction CardPaid Family Leave (PFL)Paid Parental Leave Application - AmendedPaid Parental Leave Cover PagePaid Parental Leave Policy UpdatePhased Retirement Application for FacultyPhased Retirement Application for Professional StaffPhased Retirement ProgramPremium Conversion FormPrescription Drug Exemption Request FormPSC Welfare Fund Change of StatusPSC/CUNY Application for Welfare Fund Benefits for Domestic PartnerPSC/CUNY Death Benefit DesignationPSC/CUNY Delta Dental ClaimPSC/CUNY EnrollmentPSC/CUNY Extended Medical Benefit Claim Form – For Employees with GHIPSC/CUNY Guardian Non-Participating Dental ClaimPSC/CUNY Hearing Aid ReimbursementPSC/CUNY Retiree EnrollmentReasonable Accommodation Form - EmployeeReasonable Accommodation Form - Health Care ProviderRetiree ApplicationRetiree Change of AddressRetiree Email Request FormRetirement Election FormRetirement Leave of Absence Request (TRAVIA)Salary Reduction Agreement -TIAA-CrefTax Deferred Annuity ProgramTerminal Leave FormTIAA-CREF Medicare Part B Premium Reimbursement TIAA-CREF Multiple PositionsTIAA-CREF Optional Retirement Program – Online EnrollmentTIAA-CREF Supplemental Retirement Annuity – Online EnrollmentTravia Leave PacketTRS Benefits For Tier IV MembersTRS Benefits For Tier VI MembersTuition Fee WaiverTuition Waiver AddendumWorker’s Compensation Claim Forms Employment Services & Talent Acquisition Adjunct Faculty Position Request FormAdjunct Workload Reporting FormAppendix A to C- Performance Evaluation Form for Classified EmployeesCampus Peace Officer Performance AppraisalClassified Evaluation FormClassified External Employment Approval Form Classified Managerial – Performance Accountability AssessmentClassified Reinstatement Request FormCollege Assistant Position Request FormElectronic Human Resources Action FormExecutive Compensation Plan (ECP) Evaluation InstructionsExecutive Compensation Plan (ECP) Evaluation FormFull-Time Position Request FormHEO & Classified Staff Committee Action Request Form (You must download and save the form to use the electronic signature feature)HEO & Classified Staff Committees MemoHEO Evaluation FormHEO Evaluation Form – esign (You must download and save the form to use the electronic signature feature)HEO Labor Management Committee Assignment Differential ApplicationHEO Labor Management Committee Work LoadHEO Reclassification FormInter-CUNY Transfer Request Form- For Classified Staff Multiple Position Form – MemoMultiple Position Form for FT FacultyMultiple Position Form for Non-Teaching Instructional StaffSalary Differential Request Human Resources Information Systems Change of AddressData Report Request FormEmployee ID LookupEmployee Self Service/Claim Your CUNYFirst AccountEmployee Self Service - Public Service Loan Forgiveness in CUNYFirstGender Change Request FormHow to use and navigate Peoplesoft 9.2Person of Interest FormPreferred Name Request Form Payroll and Time & Leave Adjunct Workload Reporting FormCET-Continuing Education Teacher College Assistant/Hourly/Student Aide College Lab Tech - Adjunct - PendingCUNY Employee Holiday and Annual Leave Schedule 2025-2026Direct Deposit FormEtimeFT Classified - White Collar (COA, IT, etc.)FT Classified- Blue Collar (Facilities, Public Safety) FT Classified- Blue Collar (Skilled Trades Only) HEO CT/OT FormIT2104-City and State Certificate of Tax WithholdingMail Authorization/Check Reissue RequestNon-Teaching (AJC) TimesheetPayroll Calendar - ECPPayroll Calendar - Full Time EmployeesSubmission Schedule- FTSubmission Schedule- PTTeaching Adjunct Pay Check Schedule - Summer 2025Teaching Adjunct Pay Check Schedule - Fall 2025, Winter 2026, Spring 2026Vacation Request Form Classified TitlesW4- Federal Tax form