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 866-562-8421 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

New York State Paid Family Leave Forms:
To report a leave, for Paid Family Leave, it is easiest to call 866-562-8421 to reach Cigna. Cigna will do the work for you from there, meaning no paperwork from you on your end. However, if you want to report a claim via paper form, please see below.

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

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

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

3. Final Written Warning accompanied with a Performance Improvement Plan

4. Termination

Tuition Remission/Tuition Exchange:

Taxability of Tuition Remission for Graduate Courses

Application for Employees

Application for Dependents

Human Resources Forms:
Miscellaneous Forms:
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