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The Human Resources Forms on this page were created as Adobe PDF documents. You'll need the free Adobe Acrobat Reader to view and print these forms. |
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| See also: Recruitment Manual and Hiring Guidelines Forms Samples. | ||||||
 Employment-related forms: |
(See also: Benefits-related forms) | |||||
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Employment Transaction Form Used by hiring officials for Step 1 of the 8-Step Hiring Process, identifying or creating a vacant position. |
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Position Approval Form Used to initiate the process to fill a new or vacant faculty position. |
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Recruitment Plan Tracking tool for employee recruitment action items and activities. See 8-Step Hiring Process. |
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Candidate Personal Interview Evaluation Used by hiring officials for Step 4 of the 8-Step Hiring Process |
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Employment Eligibility Verification Form (I-9) Used to comply with the Immigration Reform and Control Act of 1986 (IRCA). |
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Appeal of Disciplinary Action Form |
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Telephone Reference Check Three must be completed and signed for each candidate before a candidate can be hired. |
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Affirmative Action Approval Forms: Faculty Staff |
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Performance Management Tool Used by hiring officials for Step 2 of the 8-Step Hiring Process, filling a vacant or new position. |
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Position Reclassification Form Used to change an employee’s status or classification. |
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Federal Tax Withholding (W-4) This form must be submitted to the RPI Payroll Office. |
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NY State Tax Withholding (IT-2104) This form must be submitted to the RPI Payroll Office. |
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NY State Cetificate of Exemption from Withholding (IT-2104-E) This form must be submitted to the RPI Payroll Office. |
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Exempt Staff Supplemental Pay Authorization | |||
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Employment Separation Checklist |
| Benefits-related forms: |
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Employee Benefits Enrollment Form Enroll in health, dental, long-term disability, life, flexible spending, or supplemental insurance. |
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Retiree Enrollment Form Enroll in retiree health or dental plans (if eligible). |
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Rensselaer @ HARTFORD Benefit Enrollment Form Enroll in health, dental, long-term disability, life, flexible spending, or supplemental insurance. |
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Metlife Dental Claim Form |
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Retirement Program Enrollment Form To enroll in the Defined Contribution Retirement Program. |
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Supplemental Retirement Program Enrollment Form Salary Reduction Agreement. |
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Tuition Scholarship Request Form |  |
Professional Development Registration Form Register for development and training courses. |
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Dependent Care Flexible Spending Reimbursement Form Reimbursement for any dependent care expenses. |
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MEDICAL Flexible Spending Plan Reimbursement Form Reimbursement for any medical expenses. |
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Dependent Care Provider's Identification and Certification (W-10) This form must be submitted to the Flexible Spending Plan Administrator. |
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Dependent Care Certification Form - This form is required for all dependent care reimbursements. |
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Life Insurance Beneficiary Designation You should be sure that there is an up-to-date Beneficiary Designation Form on file in Human Resources. |
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Limit Life Insurance Form | |||
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Name/Address Change Form |
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Non-Exempt Short Term Disability Form Completion of this form is required for absences in excess of five (5) business days. |
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Occupational/Illness Injury Form Report any occupational injury or illness immediately to your supervisor! |
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