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.

Physical and Medical Requirement forms are available under Employee Health Service.

Department of Civil Service Forms
Form Title PDF Word Template
55 b/c Appointment Request Form S-90.pdf S-90.dotx
Authorization for Disability Record T-252.pdf  
Authorization for Verification of Non-Disabled Veteran Credits Use T-252a.pdf  
Candidate Disqualification Request Form ADM-155.pdf
Canvass Letter-Eligible List S-60.pdf S-60.dotx
Canvass Letter-Eligible List (Page 2 ONLY) S-60.page2.pdf S-60.page2.dotx
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.dotx
Disposition of Veterans Credits S-203.pdf  
Employee Application for Change in Title or Salary CC-2E.pdf  
Existing Position Description (CC-3) CC-3.pdf  
Evaluations of Foreign Education S-916.pdf  
HIPAA Privacy Complaint ADM-302.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
Agency Request for Access to Civil Service Department Systems IRM 300.pdf  
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.dotx
Request to Change Individual Status on Interdepartmental Promotion Eligible Lists S-211.1.pdf S-211.1.dotx
Request for Reconstructed Seniority Date Under Section 80.3 or 80a.3 S-202.pdf S-202.dotx
Request for Reinstatement S-46.pdf S-46.dotx
Workers with Disabilities Program Application Packet (55-b program) Application Packet Application Packet
Veterans with Disabilities Program Application Packet (55-c program)
Civil Service Commission Forms
Form Title PDF 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.dotx
Leave of Absence Extension CSC-2.pdf CSC-2.dotx
Civil Service Commission Appeal Form CSC-3.pdf CSC-3.dotx