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Retirees
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Contact Information
315-859-4302

Forms Available on the Web

The links below are offered to facilitate easier access to the forms that employees use most often. Please contact Human Resources, ext. 4302 with any questions regarding these forms.

Change of Address/Personal Information

Independent Contractor Forms (W-9)

Health Insurance
MVP Enrollment Form
Third Party Authorization
College Student Waiver
On-Line College Student Waiver Form
Mail Service Prescription Order Form
On-Line Prescription Refill
Prescription Reimbursement Form
MVP Dental Claim Form  (for children on POS plan only)
MVP Change of Address Form
MVP Medical Reimbursement Form

Dental and Vision Insurance
Dental/Vision Enrollment Form
Dental Claim Form (Certificate No. is on dental card)
Vision Claim Form (for out-of-network services only)
Authorization for Release of Protected Information

Domestic Partner Acknowledgement

Flexible Spending Accounts (FSA)
2008 Payflex Enrollment Form
2008 PayFlex Direct Deposit Authorization Form
2008 PayFlex Claim Form and Claim Filing Instructions

Life Insurance
Designation of Beneficiary Form
(For other forms, please contact Human Resources, ext. 4689)

Retirement Plans
Salary Reduction Agreement (403b Contributions)

Request for Tuition Benefits for Dependent Children

Employee Tuition Benefits
Application for Horizons Program
Application for Part-Time Study
Hamilton Honor Code
Immunization Record
Course Change Form
Tuition Waiver Request (Employee)
Tuition Waiver Request (Spouse/Partner)

Employment
General Employment Application
Summer Employment Application (available January 1-March 30)
Background Information Release (Criminal, Credit and/or DMV Record)

Payroll
Employment Authorization
Direct Deposit
I-9: Employment Eligibility Verification and Instructions
2008 IT-2104 (all employees must complete this form in order to work in New York State)
2008 W-4: Federal Employee's Withholding Allowance Certificate

 

Other

New York State Disability Claim Form

Parental Leave Request Form

Leave Bank Forms
M&O Leave Bank Donation Form
M&O Leave Bank Withdrawal Form
Staff Leave Bank Donation Form
Staff Leave Bank Withdrawal Form

Performance Assessment
Performance Assessment (Supervisor)
Performance Assessment (Self)

Worker's Compensation
Supervisor's Accident Investigation Report 
Accident Reporting Procedures
Information Release
Medical Provider Information

Policy Guidelines

Affirmative Action Policy Conflicts of Interest Drug-Free Workplace Policy Emergency Response Procedures Employment of Relatives Exposure Control Plan Harassment Policies Parental Leave Policy Protection of Employees Reporting Financial Misconduct Reporting Ethics Violation Concerns Travel & Entertainment ITS Policies

Scenes @ Hamilton

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