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(pdf) S-90.dotx(dot)
Authorization for Disability Record T-252.pdf(pdf)  
Authorization for Verification of Non-Disabled Veteran Credits Use T-252a.pdf(pdf)  
Candidate Disqualification Request Form ADM-155.pdf(pdf)
Canvass Letter-Eligible List S-60.pdf(pdf) S-60.dotx(dot)
Canvass Letter-Eligible List (Page 2 ONLY) S-60.page2.pdf(pdf) S-60.page2.dotx(dot)
Canvass Letter-Reemployment List S-61.pdf(pdf) S-61.dot(dot)
Canvass Letter-Redeployment List S-62.pdf(pdf) S-62.dot(dot)
Canvass Letter-ARTLs S-63.pdf(pdf) S-63.dot(dot)
Confirmation of Declination-Regular Eligible List S-64.pdf(pdf) S-64.dot(dot)
Confirmation of declination-ARTLs S-65.pdf(pdf) S-65.dot(dot)
Confirmation of Declination-Reemployment List S-66.pdf(pdf) S-66.dot(dot)
Disability Record Authorization S-7.pdf(pdf) S-7.dotx(dot)
Disposition of Veterans Credits S-203.pdf(pdf)  
Employee Application for Change in Title or Salary CC-2E.pdf(pdf)  
Existing Position Description (CC-3) CC-3.pdf(pdf)  
Evaluations of Foreign Education S-916.pdf(pdf)  
Medical Examination, Agency Request for EHS-707.pdf(pdf)  
Medical Information, Authorization for Release and Disclosure of EHS-742.pdf(pdf)  
Medical Information, Authorization for Drug/Alcohol Testing and Release of EHS-752.pdf(pdf)  
Medical Information to a State Agency, Authorization for Release and Disclosure of EHS-742-4.pdf(pdf)  
NYSTEP Access Request IRM 303.pdf(pdf) IRM 303.dot(dot)
Agency Request for Access to Civil Service Department Systems IRM 300.pdf(pdf)  
Occupational Health Examinations, Agency Request for EHS-699.pdf(pdf)  
Preplacement Physical Examination Request EHS-769.pdf(pdf) EHS-769.dot(dot)
Reinstatement Examination Request EHS-705.pdf(pdf)  
Request for Eligible List Status Change S-211.pdf(pdf) S-211.dotx(dot)
Request to Change Individual Status on Interdepartmental Promotion Eligible Lists S-211.1.pdf(pdf) S-211.1.dotx(dot)
Request for Reconstructed Seniority Date Under Section 80.3 or 80a.3 S-202.pdf(pdf) S-202.dotx(dot)
Request for Reinstatement S-46.pdf(pdf) S-46.dotx(dot)
Workers with Disabilities Program Application Packet (55-b program) Application Packet(pdf) Application Packet(dot)
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(pdf) CSC-1.dotx(dot)
Leave of Absence Extension CSC-2.pdf(pdf) CSC-2.dotx(dot)
Civil Service Commission Appeal Form CSC-3.pdf(pdf) CSC-3.dotx(dot)