BENEFITS FORMS, POLICIES, and PROCEDURES
Families First Coronavirus Response Act Forms
Family Medical Leave Act (FMLA)
- Family Medical Leave Act (FMLA) Policy
- Family Medical Leave Act Employee Guide
- Family Medical Leave Act (FMLA) Request Form
- Family Medical Leave Act (FMLA) Notice of Eligibility and Rights and Responsibilities
- Family Medical Leave Act (FMLA) Designation Notice
- 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 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 Qualifying Exigency for Military Family
- Family Medical Leave Act (FMLA) Fitness for Duty
- Application for Non-FMLA Medical Leave
- Non-FMLA Medical Leave Designation Form
- Non-FMLA Fitness for Duty Certification
Retirement
- Salary Reduction Agreement -TIAA-Cref
- CUNY Universal Annual Notice TDA Letter
- New York City Employees’ Retirement System Enrollment
- NYS Deferred Comp Enrollment Form
- NYS Deferred Comp Enrollment Kit
- New York City Teachers’ Retirement System Enrollment
- New York City Teachers’ Retirement System Designation of QPP Beneficiary
- New York State Deferred Compensation 457 Plan
- Phased Retirement Application for Faculty
- Phased Retirement Application for Professional Staff
- Phased Retirement Program
- PSC/CUNY Retiree Enrollment
- Retiree Application
- Retiree Change of Address
- Retiree Email Request Form
- Retirement Election Form
- Retirement Leave of Absence Request (TRAVIA)
- 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
- TRS Benefits For Tier IV Members
- TRS Benefits For Tier VI Members
Health Benefits
Catastrophic Sick Leave Bank and Dedicated Sick Leave Program
- Catastrophic Sick Leave Bank Program Information
- Catastrophic Sick Leave- Application to Donate
- Catastrophic Sick Leave- Application to Receive
- Catastrophic Sick Leave- Application to Withdraw and/or Change Donation
- Dedicated Sick Leave Program
- Dedicated Sick Leave- Application to Donate
- Dedicated Sick Leave- Application to Receive
Child Care Leave of Absence/Paid Parental Leave
NYSHIP Application
Paid Family Leave (PFL) Forms and Information
PSC/CUNY and DC37
- PSC/CUNY Death Benefit Designation
- PSC/CUNY Application for Welfare Fund Benefits for Domestic Partner
- PSC Welfare Fund Change of Status
- Davis Vision Claim Form
- 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
- Prescription Drug Exemption Request Form
- CVS Caremark Mail Order Form
- DC37 Change of Status Form
- DC37 Dental Claim
- DC37 Enrollment
Transit Benefits
Other
- Application for Leave for Special Purposes: Instructional Staff (Teaching and Non-Teaching) Only
- Change of Address Benefits Form
- Domestic Partner, Same Sex Marriage or Civil Union- Information Packet
- Leave for Breast and Prostate Cancer Screening and for Blood Donation
- NY529 Enrollment
- New York’s College Savings Program 529
- NYSUT Payroll Deduction Card
- Military Leave
- Tuition Fee Waiver
- Tuition Waiver Addendum
- Worker’s Compensation Claim Forms
EMPLOYMENT SERVICES
- Adjunct Faculty Position Request Form
- Appendix A to C- Performance Evaluation Form for Classified Employees
- Classified External Employment Approval Form
- Classified Managerial – Performance Accountability Assessment
- Classified Reinstatement Request Form
- Classified Evaluation Form
- College Assistant Position Request Form
- College HEO Committee Form Reclassification
- CUNY Workload Reporting Form
- ECP Executive Competencies Form
- Electronic Human Resources Action Form
- Full-Time Position Request Form
- HEO & Classified Staff Committees Memo
- HEO & Classified Staff Committee Action Request Form
- HEO Evaluation Form – esign (You must download and save the form to use the electronic signature feature)
- HEO Evaluation Form
- HEO Labor Management Committee Assignment Differential Application
- HEO Labor Management Committee Work Load
- Inter-CUNY Transfer Request Form- For Classified Staff
- Multiple Position Form for Non-Teaching Instructional Staff - Application
- Multiple Position Form for Non-Teaching Instructional Staff – Memo
- Public Safety Performance Appraisal
- Salary Differential Request
HUMAN RESOURCES INFORMATION SYSTEM
PAYROLL AND TIME & LEAVE
Calendars
Forms
Timesheets