Forms

PLEASE NOTE: You will need to have Adobe Acrobat Reader installed on your computer in order to view some forms. If your computer does not have Adobe Acrobat Reader installed, you may download it for free from http://www.adobe.com/products/acrobat/readstep2.html

Below you will find links to some of the forms and resources from the Office of Human Resources. If you need a form that is not listed below, please contact the Office of Human Resources directly at 212-650-7226.

Benefits Forms

Discipline Guidance (Classified Staff only)

Employee WorkPlace Hazards Survey

Leaves

• Scholar Incentive Award Application- Application Deadline: November 1 for the next Fall semester and March 1 for the next Spring semester
• CCNY Faculty Fellowship Award Leave Application- All Fellowship Leave applications must be submitted to HR at HumanResources@ccny.cuny.edu no later than January 31.
• Instructional Staff Academic Leave- Special Leave without Pay

Performance Management

• HEO Evaluation Form 2020
• Classified Staff Evaluation Form 2020
• Performance Management Training Presentation
• FAQ's Performance Management
• CUNY Professional Development

Multiple Position Forms

• Faculty Multiple Position Form- allows E-Signature (revised 1.20.2021)
• Faculty Multiple Position Form- allows Digital Signature (revised 1.20.2021)
• HEO, CLT's, Research Assistants & Research Associates- Multiple Position Form
• Classified Staff External Job

Recruitment & Search Related Forms

• VRB Form- Vacancy Review Board Request Form- Updated Nov. 2022 and CUNY Vacancy Review Board Guidelines & FAQs
• Recruitment Plan Approval Form (for Academic Positions)
• Recruitment Plan Approval Form (for Non-Academic Positions)
• Confidentiality Statement
• CV/Resume Evaluation
• Proposed Interviewees Form
• Interview Rating Form
• Search Certification Form
• CUNY Search Committee Guide

New Hire Forms

PAF 7 (Personnel Action Form) Full Time & Part Time Appointments (Revised Form Nov. 2022)

• CUNY Approved Foreign Education Evaluation Services
• CUNY Employment Application Full Time Part 1
• CUNY Employment Application Full Time (Part 1 & 2)
• CUNY Employment Application (Part 2)
• CUNY Employment Application (Part 3)
• I-9 Employment Eligibility Verification (Revised 2024)
• New Employee Compliance Notification Sheet for Sprintax
• Direct Deposit Form (Tax Levy Employees) updated January 2023
• Direct Deposit Conversion Election Form

Phased Retirement Program

• Phased Retirement Summary
• Phased Retirement Application - Faculty
• Phased Retirement Application - Professional Staff
• Phased Retirement Signed Agreement

Retirement Forms (Full-Time Teaching and Non-Teaching Instructional Staff)

• Teacher's Retirment System Application
• PSC-CUNY Choosing a Retirement Plan Info Sheet
• Retirement Election Form
• Retiree E-Mail Form

Request Forms

• Change of address in CUNYFirst, please view instructions here.
• Change of Personal Data Form- For former employees
• Application for Multiple Position For Non-Teaching Instructional Staff
• Employment Verification Request Form
• Non-Tax Levy Supplement Request Form
• Request for Annual Leave/Unscheduled Holidays Form
• Request for Time & Leave Balance
• Request for Reasonable Accommodation
• Reasonable Accommodation- Health Care Provider Assessment Form
• Remote Work Agreement Form
• Request for Transfer to another CUNY college (Classified Staff Only)
• Request for Transfer within City College (Classified Staff Only)
• Notice of Interest by Teaching Adjuncts for a Two-Year Appointment
• HEO - Labor-Management-Committee: Workload Concerns for HEO Series Employees Form
• College-HEO- Committee- Reclassification
• HEO-LM-Committee-Assignment-Differential
• Catastrophic Sick Leave Bank Open Enrollment
• Telecommuting/Flexible Work Schedule Request Form

Schedule of Pay Dates 2020-2021

• Adjuncts Pay Schedule- Summer 2021

• Non-Teaching Adjuncts, College Assistants, Student Aids, & IT Hourly 2022-2023

• NYSHIP Doctoral Students Tax Levy Pay Schedule 2022-2023- Doctoral Students Only (Phd.)

• Full Time Employee Pay Schedule 2020-2021Request to mail a payroll paycheck

• Full Time Faculty and Staff (Tax Levy Employees) 2021- 2022

Separation:

• Department of Labor- Record of Employment

Student FICA Tax Exemption

• CUNY Student FICA Tax Exemption Policy
• User Guide- Student Guide
• CUNYFirst Login Page
• FAQ's 2019- Student Exemption Request

Telecommuting/ Flexible Schedule

• Telecommuting/Flexible Work Schedule Request Form- Word version
• Telecommuting/ Flexible Work Schedule Request Form- PDF Version

Tax Withholding Forms

• 2024 Form IT-2104 New York State Tax Withholding Form
• 2024 Form W-4 Federal Tax Withholding Form
• IRS' Tax Withholding Estimator Tool

Time Sheets- eCT Portal

Tuition Waiver for CCNY Employee- Please deliver to Shepard Hall, rm 92 for processing

• CUNY Employee Tuition Waiver Form- updated 2020