Click below for up-to-date forms and documents for use in submitting address or name changes, W4 forms for adjusting withholding status when needed, observance of public holidays, requesting time off and more.
Contingent Workforce
- SCR Guidance
- Stop Sexual Harassment Fact Sheet
- Stop Sexual Harassment Fact Sheet – Spanish
- Stop Sexual Harassment Notice
- Stop Sexual Harassment Notice – Spanish
Employee
- Agency Privacy Requirements for Noncriminal Justice Applicants
- Cloud Computing Services
- Request to Employ Retiree Form 2366
- Address Change 1127 Waiver
- Principles of Professional Conduct
- NY Correction Law – 23 A
- Privacy Act Statement
- Noncriminal Justice Applicant’s Privacy Rights
- DOI NYS Tax Release
- Form I-9
- Form I-9 Instructions
- IT Resources Acceptable Use Policy
- Moonlighting (COIB) Waiver Procedures
- O.P. 20-22 Employment of Public Service Retirees
- O.P. 50-1 Corporate Compliance & Ethics Program
- SCR Guidance
- Stop Sexual Harassment Fact Sheet
- Stop Sexual Harassment Fact Sheet – Spanish
- Stop Sexual Harassment Notice
- Stop Sexual Harassment Notice – Spanish
- Summer Schedule CY 2025
- Nurse Residency Program Brochure
Health Benefits
- Health Benefits Application
- Dependent Eligibility Documentation Requirements
- Management Benefits Enrollment Forms
- Vision Care Claim Form
- Healthplex Dental Claim Form
- Health and Fitness Reimbursement Claim Form
- HIP HMO Opt-Out Request Form
- Superimposed Major Medical Claim Form
- Superimposed Major Medical Part D Form
- MBF HIPAA Form
- COBRA Continuation of City Health Plan Coverage
- COBRA Application for continuation of the Superimposed Major Medical Plan (SMMP) and/or Dental and Vision Care Benefit Programs (NOT FOR COBRA CONTINUATION OF CITY HEALTH PLAN COVERAGE)
- Young Adult Dependent Direct Pay Coverage Continuation; (DPCC) Form
- Video Display Terminals Program entitles eligible employee to vision examinations, lenses and frames, where necessary, biennially. Click here for information on how to access a “VDT Occupational Vision Care Program Benefit Authorization Form.”
Labor Relations/EEO
- Reasonable Accommodation Request form
- EEO Complaint Intake Form
- Prohibited Retaliatory Personnel Action by Employers
Leaves of Absence
- Application to Donate Dedicated Sick Leave Under Continuation Program
- Application to Receive Dedicated Sick Leave Under Continuation Program
- Request for Discretionary Sick Leave Form
- Request for FMLA, Child Care Leave and/or Military Leave Form SR-71 (NEW FORM)
- Certification of Health Care Provider for Employee’s Serious Health Condition FMLA: Form 2677
- Certification of Health Care Provider for Family Member’s Serious Health Condition Family and Medical Leave Act (FMLA) Form 2678
- Certification for Serious Injury or Illness of Covered Service Member/Veteran for Military Family Leave Form 2679
- Certification of Qualifying Exigency For Military Family Leave Family and Medical Leave of Absence ( FMLA) Form 2680
Retirement
- NYCERS – New York City Employees’ Retirement System
- Enrollment
- Loan Application – Tier 3, Tier 4, and Tier 6 Basic and Special Plan
- Final Pay Check Lump Sum
- Beneficiary
- Service Retirement Kits
- NYCERS Most Requested Forms
Safety & Wellness
- Workplace Violence Prevention FAQ
- Workplace Violence Incident Form 2829 (Download Paper form here)
- Workplace Violence Incident Form 2829 (Electronic Reporting)
Taxes – Income Withholding
- Federal W4 Employee’s Withholding Allowance Certificate
- Employee’s Withholding Allowance Certificate IT-2104