Online Forms

Statements Regarding Collection of Social Security Numbers on Forms

SSN required on University employment forms:
Federal tax regulations require the University of Connecticut Department of Human Resources to collect a social security number (SSN) from every employee who is paid compensation.  Employee SSN’s are maintained and used by the University for payroll and benefits purposes, to verify employment history, and where required by law or for benefits purposes, to report the employee’s SSN on Federal and state agency forms.  Except as mandated by law or as required for benefit purposes, the University will not disclose an employee's SSN to any person or organization outside the University without the employee’s prior consent.  Failure to provide a SSN to the University of Connecticut on required Human Resources forms may result in the withdrawal of an offer of employment and/or the denial of benefits.  For more information on the use of SSN’s at the University of Connecticut, please visit http://www.ssn.uconn.edu.

SSN required by third party form (such as benefit form):
At times the University of Connecticut may provide University employees with forms on behalf of benefit providers and other organizations.  Many of these forms require you to provide your social security number (SSN). As private companies it is within their rights to require you to provide your SSN in order to provide the requested service. These services typically include but are not limited to health and life insurance, retirement benefits, and employment verification.  In addition, many State and Federal forms will also request your SSN.  These forms may include, but are not limited to:  tax and other compensation-related forms, background check forms for security sensitive positions, immigration forms, and forms for other government services.  If you feel one of these third parties has misused your SSN, your first recourse is to contact the third party directly.

FORM NAME	PDF FORMAT	WORD FORMAT	MORE INFO
Accident Report (see First Report of Occupational Injury or Disease)
Acknowledgement of Temporary Appointment	PDF	WORD
Administrative and Residual Service Rating Form - Per 127 (P-5)	PDF	WORD
Address and Name Change Form (See Personal Change Form)
Address and Name Change Form (GRAD STUDENTS CLICK HERE)
Affiliate NET ID Request Form	N/A	WORD
Alternative Work Schedule Selection Form (P-5)	PDF	WORD
Application for Employment
Bargaining Unit Change Form	PDF
Budget Certification for Employment Form	PDF	WORD
Classified Request to Carry Over Vacation into 2012	N/A	WORD
Classified Search Report	PDF	WORD
Classified Staff Recruitment - AAP-2 Card	PDF	WORD
Clerical Service Rating Form - Per 126 (NP-3)	PDF	WORD
Compensatory Time Accrual Request Form	PDF	WORD
Compensatory Time Payment Authorization Form	PDF	N/A
Conflict of Interest Disclosure Form	PDF
Domestic Partnership Affidavit	N/A	WORD
Dual Employment Form	PDF
Employee Information Sheet for Special Payroll	PDF	WORD
Employment Separation Form	PDF	WORD
Essential Staffing Request Form	PDF
Faculty Hiring Form		WORD
Faculty Leave Request Form (Use for all leaves other than Sabbatical Leave and Family/Medical Leave)		WORD
Faculty Research Certification		WORD
First Report of Occupational Injury or Disease	PDF	N/A
Flextime Schedule Selection Form (NP-3)	PDF	WORD
FMLA Request Forms
Furlough Day Record		WORD
General Service Rating Form - Per 125 (NP-5, NP-6, P-4)	PDF	WORD
Genesys and Focus Access Request Form	N/A	WORD
Health Insurance Qualifying Status Change Form	PDF
I-9 Form	PDF	N/A
Job Change Questionnaire for Non-Teaching Professionals	PDF	WORD
Longevity	PDF	WORD
Maintenance Service Rating Form - Per 148 (NP-2)	PDF	WORD
Medical Certificate
Military Leave Request Form	PDF
Moving Expense Reimbursement Form	PDF	WORD
NP-2 Seniority Waiver Form		WORD
NP-3 Employee Request to Rearrange Work Schedule	PDF	WORD
(NP-3) Administrative Clerical Bargaining Unit - UCONN Geographic Transfer List Request	PDF
Personal Change Form	PDF	N/A
Personal/Emergency Leave without Pay Form		WORD
Privacy Code Change Form	PDF	N/A
Professional Paid Advertising Supplement	PDF	WORD
Professional Staff Evaluation Form	PDF	WORD
Professional Staff University Merit Form	PDF	WORD
Reclassification Request for Research Assistant/Research Associate/Academic Assistant	PDF	WORD
Report Request Form
Request for Schedule Modification (P-5)	PDF	WORD
Resignation Form	PDF	WORD
Sabbatical Leave Request Form	N/A	WORD
Sabbatical Modification Form	N/A	WORD
SEBAC Rights for UCPEA End Date Nonrenewals
Separation Form	PDF	WORD
Social and Human Services Rating Form (P-2)	PDF	WORD
Special Payroll Authorization	PDF	EXCEL
Temporary Flexible Schedule Request for Managerial/Confidential Employees	PDF	WORD
UCPEA Internship Request Form	N/A	WORD
Temporary Flexible Schedule Request for UCPEA Employees	PDF	N/A
Voluntary Schedule Reduction Program Application	N/A	WORD
Waiver of Union Representation Form	PDF	WORD
Worker's Compensation Filing Status and Exemption Form	PDF	N/A

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