human resources Forms

These documents are for SCSU  use only and should not be modified without consent from the SCSU Human Resources Department.

FREQUENTLY USED FORMS

Clerical Tuition Waiver
Confidentiality Statement
Direct Deposit
Dual Employment
Name/Address Change
W-4 CT Tax Form 2013
W-4 Federal Tax Form 2013
I-9 Employment Eligibility Verification

EMPLOYMENT FORMS

• Application (State - HR-12, Classified Employees Only)
  • Background Investigation Authorization
    • Governor Rell's Ethics Statement
      • Graduate Assistant Appointment Form
        • Lecturer Appointment
          • Part Time Counselor Form
            • Personnel Action Form
              • Student Work Authorization Form
                • University Assistant Appointment Form

Faculty Related Forms

• 10.12 Instructional Faculty Timesheet
  • AAUP Consulting Research Approval Form
    • Article 11 Compensation for Non-Instructional Educational Activities Form (Full-Time)
      • Article 12.8 Non-Instructional Educational Activities Form (Part-Time)
        • Instructional Faculty Authorization Form (10.12)
          • No Load Credit Form (10.12.1)
            • Outside Teaching Employment Request Form
              • Request for Time and/or Allocation Split

EVALUATION FORMS

• Administrative Faculty
  • Administrative and Residual
    • Clerical
      • Maintenance
        • Management/Confidential

medical RELATED FORMS 

• FMLA -HR1 Employee Request
  • FMLA - HR2a Agency Response: Notice of Eligibility & Rights & Responsibilities
    • FMLA - HR2b Agency Response: Designation Notice
      • FMLA - HR2c CORE CT Coding
        • FMLA - HR3 Intent to Return to Work
          • Employee Med Cert Form (P33-A)
            • Caregiver Med Cert Form (P33-B)
              • Military Family Leave Form (WH-384, Employee)
                • Military Family Leave Form (WH-385, Service Member)
                  • Reasonable Accommodation Request Form
                    • Sick Leave Bank Grant Application - AAUP
                      • Sick Leave Bank Grant Application - Management/Confidential
                        • Sick Leave Bank Grant Application - SUOAF

retirement forms

• Income Payment Election Form - Option A (50% Spouse)
  • Income Payment Election Form - Option B (50% or 100% Survivor)
    • Income Payment Election Form - Option C (10 or 20 Years Period Certain)
      • Income Payment Election Form - Option D (Straight Life Annuity)
        • Limited Durable Power of Attorney Form (CO-1049)
          • Retirement Form (CO-931H)

Worker's Compensation Forms

WC Forms for supervisors

• Reference Guide
  • Supervisor's Check List
    • WC 207 First Report of Injury
      • WC 207-1 Accident Investigation Report

WC Forms for employees

• Employee's Check List
  • General Letter 78: Use of Accrued Leave with Worker's Comp
    • WC 715 Use of Accruals
      • WC 1A  Filing Status
        • WC 211 Liability
          • WC Physician's Status Report
            • WC Employee Notice

other Forms

• Duties Questionnaire
  • Incident Report - Facilities Operations
    • Incident Report - SCSU
      • Workplace Violence Reporting Form