| Benefits |
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| Disability/FMLA/Life Insurance |
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| ► FMLA Leave Request Form |
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| ► FMLA Medical Certification |
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| ► Notice and Proof of Claim for Disability Benefits |
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| ► Prudential Life Insurance Enrollment/Beneficiary Form (Fac/Admin only) |
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| ► First Reliance Designation of Beneficiary |
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Flexible Spending (Fordham Account Number 1067533) |
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► 2008 Flexible Spending Enrollment Application
► 2009 Flexible Spending Enrollment Application (This form is for clerical employees only.) |
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| ► Dependent Care Reimbursement Form |
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► Health Care Reimbursement Form
► Prescription Reimbursement Form
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| Medical & Dental |
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| ► Aetna Enrollment Application |
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| ► Cigna Enrollment Application |
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| ► Cigna Medical Claim Form |
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| ► Empire Enrollment Application |
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| ► Empire Dental Claim Form |
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| ► Empire Health Insurance Claim Form |
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| ► Empire Prescription Drug Claim Form |
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| ► HIP Enrollment Application |
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| ► Medical/Dental Authorization Form |
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| ► MMC Aetna Dental Enrollment Application |
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| ► MMC Aetna Dental Claim Form |
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| ► Oxford Coordination of Benefits |
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| ► Oxford Enrollment Application |
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| ► Oxford Student Verification Parent Affidavit |
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| Retirement |
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| ► Clerical Salary Reduction Agreement |
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| ► Faculty and Administrator Benefits Waiver and Deferral Form |
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| ► Faculty and Administrator Salary Reduction Agreement |
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| ► Fidelity Enrollment Application |
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| ► Fidelity Roth SRA Salary Reduction Agreement |
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► Fidelity Transfer/Rollover Form
► Maintenance Salary Reduction Agreement |
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| ► Prudential Beneficiary Designation Form |
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| ► Prudential Enrollment Application |
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| ► Prudential Transfer/Rollover Form |
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| ► TIAA-CREF Faculty & Administrative Plan Enrollment Application |
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| ► TIAA-CREF Clerical & Maint Retirement Plan Enrollment Application |
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| ► TIAA-CREF Transfer/Rollover Form |
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► TIAA-CREF Fac &Admin TDA Plan Enrollment Form
► TIAA-CREF Fac & Admin Retirement Plan Enrollment Form |
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Tuition Remission |
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| ► Dependent and Spouse Tuition Remission Form |
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| ► Employee Tuition Remission Form |
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| ► Tuition Exchange Form |
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| Employment |
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| Employment Forms |
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| ► Administrative Probation Form |
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| ► Clerical and Maintenance Probation Form |
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| ► Directory Update Form |
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| ► Directory Update Form (Removal) |
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| ► Employment Application |
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| ► Exit Interview Questionnaire |
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| ► Employment Eligibility Verification Form (I-9) |
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| ► ID Card Request Form |
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| ► Independent Contractor Status Checklist |
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| ► Notification of Administrative Vacancy |
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| ► Notification of Maintenance Vacancy Form |
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| ► Parking Permit Application |
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| ► Parking Pre-Tax Form 2005-B |
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| ► Record of Hiring Report |
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| ► Referral Form for Clerical Employees |
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| ► Request for Employment Advertisement (submit online) |
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| ► Request for Office Temp (submit online) |
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| ► Clerical & Maintenance Appraisal |
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| ► Admin Appraisal |
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| Payroll |
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| Employee Transactions |
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| ► Departmental Check Designee Form |
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| ► Direct Deposit Form |
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| ► E-Trac Survey (Current Members) |
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| ► E-Trac Survey (New Members) |
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| ► Payroll Discrepancy Form |
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| ► W-2 Request Form (2007) |
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| Taxes |
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| ► IT-2104 NYS Tax Form |
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| ► IT-2104.1 Nonresident State Tax Form |
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| ► IT-2104E NYS Tax Form (for exempt status only) |
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| ► IT-2104IND NYS Tax Form |
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| ► IT-2104MS NYS Military Service Tax Form |
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