Get a Form

A                     

• ABP PERS Comparison
• ABP Retirement Election Form
• ABP Retirement Transfer Form
• Acting Appointment Form
• Address Directory Record
• AETNA Healthcare Benefit Summary
• Affidavit of Dependency
• AFSCME Bid form
• Annual Disclosure Form - Scholarly Capacity
• ARS Administrative Access Form

C

• Carrier Allocation/Salary Reduction Agreement - ABP/ACTS
• Carrier Investment Comparison Guide - ABP/ACTS
• Campus Emergency Notification
• CIGNA Healthcare Benefits Summary
• Civil Union/Domestic Partner Imputed Income Chart
• Classification and Recruitment Form (CARF)
• Classification and Recruitment Form (CARF) for 888 Positions
• Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave - Family & Medical Leave
• Certification of Health Care Provider - Employee's Serious Health Condition - Family & Medical Leave
• Certification of Health Care Provider - Family Member's Serious Health Condition - Family & Medical Leave
• Certification of Pension Membership
• Certification of Qualifying Exigency Military Family Leave - Family & Medical Leave
• Change in Co-Adjutant Commitment Form (Type 8)
• Claim Form - NJ DIRECT 15
• Claim Form - NJ PLUS
• Claim Form - Traditional Plan
• Co-Adjutant Employee Retirement Eligibility
• COBRA Application
• Compassionate Leave Program - Application for Use
• Compassionate Leave Donation - Donation to Bank (online system)
• Compassionate Leave Donation - Donation to Bank Form
• Custom Training and Facilitation Request

D

• Deferred Compensation Beneficiary Form
• Deferred Compensation Catch-up Form
• Deferred Compensation Change Form
• Deferred Compensation Enrollment Form
• Dental Expense Plan Claim Form
• Direct Deposit Application
• Disability Retirement Application - PERS
• Disability Retirement Application - PFRS
• Domestic Partners - Certificate of Pension Membership
• Domestic Partners - Employee Tax Certification
• Domestic Partners - Directory of Local Registrars
• Domestic Partner/Civil Union Imputed Income Chart
• Donor Card, Organ

E

• Emergency Notification, Campus
• Employee Personnel File Request Form
• Employee Tax Certification
• Employment Offer Letter for URA-AFT External Hires
• Employment Offer Letter for MPSC External Hires
• Employment of Public Officials Form

F

• Family & Medical Leave - Certification for Serious Injury or Illness of Covered Servicemember for Military Family Leave
• Family & Medical Leave - Certification of Health Care Provider - Employee's Serious Health Condition
• Family & Medical Leave - Certification of Health Care Provider - Family Member's Serious Health Condition
• Family & Medical Leave - Certification of Qualifying Exigency Military Family Leave
• Family & Medical Leave - Designation Notice
• Family & Medical Leave - General Poster/Notice of Employee Rights and Responsibilities
• Family & Medical Leave - General Poster/Notice of Employee Rights and Responsibilities (Spanish)
• Family & Medical Leave - Notice of Eligibility and Rights and Responsibilities
• Family Leave Insurance Claim Form
• Family Leave Insurance Notice Poster
• Family Leave Insurance Notice Poster (Spanish)
• Faculty Recruitment Summary Form (UPF-1F)
• Faculty Recruitment Summary Form (UPF-1F) Instructions
• Faculty Separation Questionnaire
• Flexible Spending Account Claim Form (Horizon Healthcare)
• Flexible Spending Account Claim Form (FBMC)
• Flexible Spending Account Change in Status Form
• Flexible Spending Account Election Form
• Formulario Para Reportar Empleo Externo Para los Empleados

G

• A Guide to Choosing a SHBP Health Plan

H

• Harassment Complaint Form - Formal Complaint (PDF version)

I

• I-9 Employment Verification Form (3 links - open and download separately)
  I-9 Employment Verification Form
  Family & Medical Leave Act Poster/Notice
  NJ Family Leave Insurance Poster/Notice
• I-9 Employment Verification Form (Spanish) (3 links - open and download separately)
  I-9 Employment Verification Form (English)
  Family & Medical Leave Act Poster/Notice (Spanish)
  NJ Family Leave Insurance Poster/Notice (Spanish)
• I-9 Employment Verification Form (Spanish) - For reference only. Do not use.
• ID/RU Connection Card Request Form
• In-Grade/Range Salary Adjustment Form

L

• Life Insurance Beneficiary Designation
• Loan Application - PERS/PFRS
• Long Term Care Insurance Enrollment Application and Insurability Questionnaire

M

• Mass Transit Commutation Reimbursement Program Part-Time Employees - Claim Form
• Mass Transit Commutation Reimbursement Program Part-Time Employees - Certification of Expenses
• Mass Transit Commutation Reimbursement Program Part-Time Employees - Election/Change Form

N

• NJ DIRECT 10 Benefit Summary
• NJ DIRECT 15 Benefit Summary
• NJ DIRECT 15 Claim Form
• NJ PLUS Claim Form
• Nomination Form: President's Recognition - Bridge Award
• Nomination Form: President's Recognition - Service Award
• Notice of Pre-Termination Conference (aligned)
• Notice of Pre-Termination Conference (non-aligned)

O

• Organ Donor Card
• Outside Employment Form, Staff (PDF)
• Outside Employment Form, Faculty (PDF)

P

• Part-Time Employees Mass Transit Commutation Reimbursement Program - Claim Form
• Part-Time Employees Mass Transit Commutation Reimbursement Program - Certification of Expenses
• Part-Time Employees Mass Transit Commutation Reimbursement Program - Election/Change Form
• Part-Time Lecturers and/or Co-Adjutant Employee Retirement Eligibility
• Pension Enrollment Application - ABP
• Pension Enrollment Application - PERS
• Pension Enrollment Application - PFRS
• PERS ABP Comparison
• Personnel File Request Form
• Pay-for-Performance Appraisal Form
• Pay-for-Performance Request for Review Form
• Postdoc Fellow Enrollment Form
• Premium Option Plan (POP) Declination Form
• Prescription Drug Mail Service Order Form
• Prescription Drug Reimbursement Claim Form
• Problem Solving Procedure - Managerial, Professional, Supervisory, or Confidential Employees
• Prudential Long Term Care Insurance Enrollment Application and Insurability Questionnaire
• Public Officials Form, Employment of
• Purchase Service Credit Application - PERS/PFRS

R

• Receipt and Acknowledgement: Rutgers Code of Ethics and
  Rutgers Plain Language Guide to Fundamental Ethics and Conflicts Rules
  Established by State Law, Federal Law, and University Policy
• Recibo y Confirmación
  Código de Conducta General de Rutgers y El Guía Sencillo de Lenguaje de Rutgers Para Los Conflictos Éticos Fundamentales
  Reglas Establecidas Por la Ley Estatal, Ley Federal y Póliza Universitaria
• Reinstatement Form, State Health Benefits Program
• Rejection Letter Sample
• Report of Transfer/Multiple Enrollment Form - PERS
• Report of Transfer/Multiple Enrollment Form - PFRS
• Retiree Tuition Reimbursement Application
• Retired Status Application, State Health Benefits Program
• Retirement Allowance Application - ABP
• Retirement Allowance Application - PERS
• Retirement Allowance Application - PFRS
• Retirement Election Form (ABP)
• Retirement Transfer Form (ABP)
• Retired Faculty Association Membership Application
• Request for Retirement Estimate - PERS
• Request for Retirement Estimate - PFRS
• RU Connection Card Request Form

S

• SACT Enrollment Form
• SACT Change of Contribution Request
• Salary Reallocation Form
• Salary Reduction Agreement - ABP/ACTS
• Salary Reduction Agreement - SACT
• Scholarly Capacity - Annual Disclosure Form
• Self-Identification Form for Individuals with Disabilities and Covered Veterans
  (MS Word fill-in form)
• Self-Identification Form for Individuals with Disabilities and Covered Veterans
  (PDF version)
• SHBP Health Plan, A Guide to Choosing a
• State Health Benefits Program Waiver/Reinstatement Form (Complete with application)
• Sick Leave, Certifications for Use (for MPSC employees)
• Sick Leave Payment at Retirement - Deferral Form
• Silver Knights/Retired Staff Membership Application
• Staff Layoff Information Form
• Staff Separation Questionnaire
• State Health Benefits Program Dental Application
• State Health Benefits Program Medical Application
• State Health Benefits Program Application - Part-Time Employees

T

• Temporary Disability Insurance Claim Form
• Temporary Job Order
• Time Reporting System Access Form
• Traditional Plan Claim Form
• Travel and Business Expense Report (TABER)
• Tuition Remission Application - Employees
• Tuition Reimbursement Application - Retiree

U

• UNUM Provident Long-Term Disability Enrollment Form
• UNUM Provident Long-Term Disability Evidence of Insurability Form
• UPF-1F Form (Faculty Recruitment Summary)

V

• Vision Care Plan Claim Form

W

• W-4 (2009)
• W-4 New Jersey
• State Health Benefits Program Coverage State Employee Waiver/Reinstatement Form
• State Health Benefits Program Coverage State Employee Waiver/Reinstatement Form (Complete with application)
• Withdrawal Application - PERS/PFRS
• Workplace Violence Incident Report

  

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Last Updated: 10/30/2009