Forms

Jump to a category:

General

• Accident/Injury report (on the job)
• Change of Address
• CSEA Hardship
• Employee Request for an Accommodation  (PDF)
• Request for Medical Information Form (PDF)
• Telecommuting Application & Work Plan (PDF)
• Voluntary Reduction in Work Schedule (VRWS)
• Workplace Violence Incident Report

Appointment

• Employment Appointment (Employment, Stipend, Extra Service, Summer, Winterim)
• Position Justification
• Salary Increase Justification
• Stipend Justification
• W-4 Federal Withholding
• IT 2104 NYS Withholding
• IT 2104-E Certificate for Exemption of Withholding
• I-9 (Open with Adobe Acrobat as this is a secured PDF)
• I-9 (non-fillable)
• Oath of Office

Annual Evaluations/Performance Programs

View the Performance Program Management Guide (PDF)

Classified Service Staff

• Classified Probation Report

Professional Employees

• Professional Performance Program - UUP and M/C Performance Program are managed through the Performance Management Module  (Use this link to log in using your CCA.  You will click on the three blue dots in the upper left-hand corner and select SUNY Potsdam Employee Portal)

Personnel Actions

• Reappointment and Promotion Schedule 2022-2023

Academic

• Academic Faculty Information Form   - (PDF)   (DOC)
• New Academic Faculty Information Form - (PDF) (DOC) *For faculty whose initial appointment date is after 7/1/2019
• Adjunct Instructor or Lecturer Faculty Information Form – (PDF) (DOC)
• Personnel Action for Academic Employees (Reappointments, Leaves, Promotions)
• Personnel Action for Department Chairs

Professional

• Personnel Action for Professional Employees (Reappointments, Leaves, Promotions)
  • Hard copy forms will no longer be accepted.  All requests must use the online qualtrics form.

Benefits Forms

• SUNY Related Insurance Information and Forms

Retirement

• ERS-Employees Retirement System forms page
• TRS-Teacher's Retirement System forms page
• SUNY Voluntary Savings Program to enroll or change your supplemental tax deferral
• Phased Retirement Programs (for UUP Faculty & Librarians, UUP & MC Professionals and CSEA, PEF & PBA)
• Retiree CCA/Email Retention Request Form

Leaves

• Leave of Absence Form (for Family medical, Military, leave without pay and other)
• FMLA Health Care Provider Certification
• Leave Donation Form
• Drescher Leave Program
• Teaching Faculty - Parental Leave Request Form
• Tenure Stop Clock Form (DOC)
• Sabbatical Leave - use Personnel Action-Academic above
• Title F Leave - use Personnel Action-Professional above

Payroll

• CSEA Overtime Form
• Direct Deposit Form
• Holiday Pay Form
• Pink Hourly Schedule of Due Dates/Paycheck Dates
• Leave Donation Form

• Extra Service - for work at home campus (Potsdam)
• Extra Service M/C employee - UP 6
• Extra Service UUP employee - UP 8 (for work at other than home campus)
• Extra Service/Dual Employment form - for Non-SUNY Potsdam Employees
• Extra Service Voucher