Forms

Here you will find forms that can save you a trip to HR. All forms that are in a PDF format require Adobe Acrobat Reader, version 4 or higher, on your computer (MAC or PC). To download this free software visit http://www.adobe.com/products/acrobat/readstep2.html and follow the instructions. You can use Ctrl-F to search within this document.

For assistance, please call the main Human Resources number at (585) 475-2424 or refer to the HR Staff Directory.

The forms below are grouped into the following sections:

Benefits Forms
General Employment Forms
Job Evaluation and Position Control Forms
Employee Action Forms
Faculty EAF
Staff EAF
Adjunct/Temp EAF
HR Transactions Quick Start Guide

Benefits Forms

Form Name	Use
Accident Report Form	To report an accident or injury that occurs at work
Adoption Assistance Program Reimbursement Form	To request reimbursement for eligible adoption expenses.
Affidavit of Domestic Partnership	To certify your domestic partner relationship.
Application for Domestic Partnership Benefits	To enroll, change, or cancel benefits for your domestic partner.
Benefits Enrollment/Change Form	To enroll, change, or cancel most RIT benefits.
Beneflex Authorization to Release Protected Health Information (PHI)	To provide your authorization to EBS to release your PHI to another person(s) or entity (PHI includes information regarding your account and your claims).
Beneflex Data Change Form	To update EBS with new information (e.g., address change)
Beneflex Direct Deposit Form	To sign up, change or cancel direct deposit of Beneflex reimbursements.
Beneflex Reimbursement (FSA) – Dependent Day Care Spending Account	To claim Beneflex dependent day care spending account reimbursements.
Beneflex Reimbursement (FSA) - Health Care Spending Account	To claim Beneflex health care spending account reimbursements.
Beneflex Request Form for Additional EBS Flex Card	To request an additional Flex Card for a family member.
Dental Claim Form	To submit dental claims to the dental plan administrator.
Job-Related Verification Form	To apply for tax waiver for graduate courses taken by RIT employees.
Medical Claim Form	To submit medical services claim for reimbursement to Excellus BlueCross BlueShield
Prescription Drug Reimbursement	To submit prescription drug claim for reimbursement to Medco
Retirement Transition Program Request Memo	To request participation in Retirement Transition Program.
Sick/Personal Time Cash-Out for 2013	For non-exempt employees to elect a taxable payment of a portion of the remaining Sick/Personal Time.
Statement of Termination of Domestic Partnership	To terminate the Affidavit of Domestic Partnership.
Tuition Assistance	To apply for reimbursement for job-related courses you take at accredited colleges and universities and to apply for department funding for CPD courses.
Tuition Exchange Application and Recertification	To apply for or recertify eligibility for the Tuition Exchange benefit.
Tuition Scholarship	To apply for reimbursement for undergraduate tuition at other accredited colleges/universities for eligible children.
Tuition Waiver Form	For regular employees to cover spouse/domestic partner and children for courses taken through the Academic Supports Center and the English Learning Center; for adjunct employees and eligible non-employees (e.g., ROTC) to cover themselves or spouse/domestic partner and children under RIT's Tuition Waiver Program for credit-bearing courses.
Tuition Waiver Benefit Form - Family Member Information	For regular employees to cover spouse/domestic partner and children under RIT's Tuition Waiver Program for credit-bearing courses.

General Employment Forms

Form Name	Use
Background Check Authorization	To grant permission for a criminal background and/or mvr check to be performed.
Background Check: Notice of Rights Under the Fair Credit Reporting Act
Cost Account Calculation Worksheet-Grant Funded Positions	To calculate account breakdowns for grant funded positions.
Disability-Related Accommodations Request	For faculty and staff to request disability-related accommodations in the workplace.
Employee Change of Personal Information	To change name, address, phone number, or emergency contact information.
Employment Application Form	It is strongly recommended that you use our automated job application systemhttp://careers.rit.edu to apply for positions at RIT. If you are unable to do so, you may fill out this form and return it to the Human Resources Department.
New Hire Personal Data Form	New faculty and staff hires will need to complete this form along with their other new hire paperwork.
New York State LENS Program MVR Form	Enrollment into New York LENS Program
Requisition Form-Faculty and Staff - NON-Grant/Contract Funded	To request a new NON-grant/contract funded incremental position.
Requisition Form-Faculty and Staff - Grant/Contract Funded	To request a new grant/contract funded incremental position. Instructions for new process can be found here
Staff Performance Appraisal Procedures and Forms	To initiate and conduct staff performance appraisals and/or upward appraisal.
Termination Checklist	To ensure all necessary actions are completed before and after employee terminates.
Transfer Checklist	The previous manager should complete this checklist when a faculty or staff member in their department is being hired into another department at RIT
Worksheet - Summer Salary	To calculate summer salary for regular employees.

Job Evaluation and Position Control Forms

Form Name	Use
Job Description Questionnaire	To be used for all new and existing Positions.
Job Description Questionnaire (JDQ) instructions	Instructions for completing the JDQ form
Job Re-evaluation/Title Change Request Form	To be used to re-evaluate existing positions or submit title changes
Job Re-evaluation/Title Change Request Form Instructions	Instructions for usage and completion of the Job Re-Evaluation/Title Change Request Form
Position Change Form	To be used submit certain changes to positions in Oracle (refer to instructions for guidance)
Position Change Form Instructions	Instructions related to the use of the Position Change Form
Re-organization/Organization Name Change Template (Excel)	To initiate a department re-organization or organization name change.

Employee Action Forms

Faculty Employee Action Forms

Faculty EAF Forms
Faculty - Hire	All hires on a requisition in Career Zone should be processed using the online EAF form in the Career Zone system. Consult the Career Zone user guide for instructions.
Faculty - Leave Start	To initiate a leave of absence RIT faculty
Faculty - Leave Return	To initiate a return to work action for RIT faculty
Faculty - Salary Redistribution	To initiate salary redistribution/costing change for RIT faculty
Faculty - Promotion/Other Change	To initiate a promotion or other action for RIT faculty. Please refer to the back of the form for further information.
Lecturer - Term Change	To be used to change or renew a multiple year term period of appointment for a Lecturer, Senior Lecturer or Principal Lecturer.
Summer Salary Grants and Contracts - EAF	To initiate summer hire action for RIT faculty on grants and contracts.
Summer Salary - EAF	To initiate summer hire action for RIT faculty not on grants and contracts.
Faculty - Termination	To initiate termination of employment for RIT faculty
Faculty Overload	To initiate Faculty Overload Pay Action for an appointment period outside of the normal quarter time frame for RIT regular Faculty Employees.
Faculty Special Assignment	To initiate Special Assignment Pay Action for RIT regular Faculty employees
Transfer Checklist	The previous manager should complete this checklist when a faculty or staff member in their department is being hired into another department at RIT
FTE Calculator	Excel spreadsheet to be used for calculating employee FTE based upon their standard months, weeks, hours

Staff Employee Action Forms

Staff EAF Forms
Staff - Hire	All hires on a requisition in Career Zone should be processed using the online EAF form in the Career Zone system. Consult the Career Zone user guide for instructions.
Staff - Leave Start	To initiate a leave of absence RIT staff
Staff - Leave Return	To initiate a return to work action for RIT staff
Staff - Salary Redistribution	To initiate salary redistribution for RIT staff
Staff - Promotion/Other Change	To initiate a promotion or other action for RIT staff
Staff - Termination	To initiate termination of employment for RIT staff
Staff Special Assignment	To initiate Special Assignment Pay Action for Exempt Staff Employees for a period of time outside of the normal quarter time frame.
Transfer Checklist	The previous manager should complete this checklist when a faculty or staff member in their department is being hired into another department at RIT
FTE Calculator	Excel spreadsheet to be used for calculating employee FTE based upon their standard months, weeks, hours

Adjunct/Temp Employee Action Forms

Adjunct/Temp EAF Forms
Temp - New Hire	To initiate new hire action for RIT Temp (non-agency)
Temp - Salary Redistribution	To initiate salary redistribution for RIT Temp (non-agency)
Temp - Promotion/OtherChange	To initiate a promotion or other action for RIT Temp (non-agency)
Adjunct New Hire/Special Contract	To initiate hire action for new Adjunct employees or for use for Special Contract timeframes outside of the normal quarter time frame. Exempt Adjunct only
Temp/Adjunct - Termination	To initiate termination of employment for RIT Temp (non-agency)
Adjunct Non-Exempt Hire/Rehire	To initiate a hire or rehire of a non-exempt (hourly) adjunct. Use only for hiring existing RIT non-exempt employees. Refer to instructions on back of form

Payroll Forms (Questions: (585) 475-2381 or (585) 475-2382)

Forms related to Kronos Timekeeping, Additional Payments, Payroll Changes and Tax Deductions can be found at:http://www.rit.edu/fa/controller/forms.html

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