Human Resource Services

Forms

For any leave of absence, you will need to contact the Office of Human Resources, 30 days before you begin your leave, to ensure all the appropriate paperwork is filled out. Please contact Kim Wyant or Kayleigh Misner to discuss your leave options.

Family Medical Leave Act Forms:
General Information Regarding Family Medical Leave
Family Medical Leave Responsibilities Checklist

Initial Form(s) to be filled out when needing to take leave:

Form to be filled out before employee can return to work if you are out for your own medical illness:

Short Term/Long Term Disability Forms:

Reporting a Short Term/Long Term Disability claim is easy, you simply call 888-842-4462 to reach Cigna. Cigna will do the work for you from there, meaning no paperwork from you on your end.

How to Report a Leave of Absence

Short Term Disability Summary

Please note: When taking this type of leave Cigna withholds FICA tax, but not federal or state tax. Income received from Short Term Disability will be adjusted and added to your W2 from AU at the end of the year. You may expect to owe money in for the federal and state taxes that you did not pay on this money when you file your tax return.

New York State Paid Family Leave Forms:

To report a leave, for Paid Family Leave, you will want to report a claim via paper form, please see below. Once the paper forms are all filled out, you can fax them to Cigna at 1-866-931-5095.

General Information Regarding Paid Family Leave
How to Report a Leave of Absence
PFL Leave Process

Please note: When taking this type of leave Cigna does not tax the amount that they provide to employees. They issue a 1099-MISC by Jan 31 of the next year and you will need to file this when filing your income taxes. You may expect to owe money in for the federal, state, and FICA taxes that you did not pay on this money when you file your tax return.

Workers Compensation:
If you are injured while at work, you need to report your accident within 24 hours of injury to ensure coverage by Workers Compensation.

Accident, Incident, Near-Miss Report

Payroll Forms

For forms such as direct deposit, W4, NYS IT-2104, and Taxable Gifts and Awards please visit the Payroll Page.

Employment Administration Forms

For forms such as the recruitment requisition, job description template, personnel action form, and the student/summer payroll authorization forms, please visit the Employment Administration page.

Public Service Loan Forgiveness Program:
Information Regarding the Program

Qualifying Factors:

  • Must work at least 30 hours a week
  • Your federal loans have to be Direct Loans to qualify
  • Your loans must be paid under an income based repayment plan
  • Have to make 120 on-time qualifying payments then the rest of your loans are forgiven
  • Complete and submit the Employment Certification for Public Service Loan Forgiveness form yearly to your loan servicer to certify your employment
  • Human Resources can certify your employment and verify employment dates

You will fill out the first page of the PSLF form, send the form to Human Resources and we will fill out the second page and send back to you.

Evaluation Forms:
Supervisor Forms:

The Process of Corrective Action:

1. Verbal Warning

2. Written Warning accompanied with a Performance Improvement Plan (HR needs to be involved)

3. Final Written Warning accompanied with a Performance Improvement Plan (HR needs to be involved)

4. Termination (HR needs to be involved)

Tuition Remission/Tuition Exchange:

Taxability of Tuition Remission for Graduate Courses

Application for Employees

Application for Dependents

Human Resources Forms:
Miscellaneous Forms:
individuals inspired
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