Forms
Department of Civil Service Forms | Civil Service Commission Forms
Selected health insurance forms are available in NYSHIP Online under either the Employees or Retirees tab.
| Form Title | Word Template | |
|---|---|---|
| Canvass Letter-Eligible List | S-60.pdf( ) |
S-60.dot( ) |
| Canvass Letter-Reemployment List | S-61.pdf() |
S-61.dot() |
| Canvass Letter-Redeployment List | S-62.pdf() |
S-62.dot() |
| Canvass Letter-ARTLs | S-63.pdf() |
S-63.dot() |
| Confirmation of Declination-Regular Eligible List | S-64.pdf() |
S-64.dot() |
| Confirmation of declination-ARTLs | S-65.pdf() |
S-65.dot() |
| Confirmation of Declination-Reemployment List | S-66.pdf() |
S-66.dot() |
| Disability Record Authorization | S-7.pdf() |
S-7.dot() |
| Disposition of Veterans Credits | S-203.pdf() |
|
| Employee Application for Change in Title or Salary | CC2E.pdf() |
|
| Existing Position Description (CC-3) | CC3.pdf() |
|
| Evaluations of Foreign Education | S-916.pdf() |
|
| Medical Examination, Agency Request for | EHS-707.pdf() |
|
| Medical Information, Authorization for Release and Disclosure of | EHS-742.pdf() |
|
| Medical Information, Authorization for Drug/Alcohol Testing and Release of | EHS-752.pdf() |
|
| Medical Information to a State Agency, Authorization for Release and Disclosure of | EHS-742-4.pdf() |
|
| NYSTEP Access Request | IRM 303.pdf() |
IRM 303.dot() |
| Occupational Health Examinations, Agency Request for | EHS-699.pdf() |
|
| Preplacement Physical Examination Request | EHS-769.pdf() |
EHS-769.dot() |
| Reinstatement Examination Request | EHS-705.pdf() |
|
| Request for Eligible List Status Change | S-211.pdf() |
S-211.dot() |
| Request to Change Individual Status on Interdepartmental Promotion Eligible Lists | S-211.1.pdf() |
S-211.1.dot() |
| Request for Reconstructed Seniority Date Under Section 80.3 or 80a.3 | S-202.pdf() |
S-202.dot() |
| Request for Reinstatement | S-46.pdf() |
S-46.dot() |
| Selective Certification for Information Technology Specialist 4 (and parenthetics) and Manager Information Technology Services 1 (and parenthetics) |
Profile Form(53KB) |
Profile Form(231KB) |
| Workers with Disabilities Program Application Packet (55-b program) | Application Packet() |
Application Packet() |
| Veterans with Disabilities Program Application Packet (55-c program) |
| Form Title | Word Template | |
|---|---|---|
Section 211 Application, Pension Waiver Pursuant to Section 211 of the New York State Retirement and Social Security Law |
CSC-1.pdf() |
CSC-1.dot() |
| Leave of Absence Extension | CSC-2.pdf() |