Employment
DMNA Application for Employment DMNA Form 1041
Outside Employment http://dmna.ny.gov/state/files/DMNA_Form_88.pdf
Personal Information/Emergency Contact
DMNA Emergency Contact Form DMNA Form 75
DMNA Personal Information DMNA Form 75-1
Health Benefits
NYS Health Insurance Transaction Form (PS 404) http://www.cs.state.ny.us/forms/ps404pe.pdf
CSEA EBF Enrollment Form CSEA Employee Benefit Fund Enrollment Form
Health Insurance Opt Out Program Insurance Opt Out Form
Health Insurance Choices https://www.cs.state.ny.us/ebd/ebdonlinecenter/choices11/actives/actives_choices_set_11.pdf
Time and Attendance
DMNA Leave Form DMNA CP7
DMNA Request Advanced Sick Leave DMNA CP8-1
DMNA Request Sick Leave at Half Pay DMNA CP8
DMNA Leave Donation Form DMNA CP9
Retirement
Designation of Beneficiary http://www.osc.state.ny.us/retire/forms/rs5127.pdf
Change of Address (Active Member) http://www.osc.state.ny.us/retire/forms/rs5512.pdf
Application for Service Retirement http://www.osc.state.ny.us/retire/forms/rs6037.pdf?utm_source=enews-employer-july13&utm_medium=email&utm_campaign=employer-hot-topics-1
Withdrawl of Application for Retirement http://www.osc.state.ny.us/retire/forms/rs6354.pdf
Payroll
Direct Deposit Form http://www.osc.state.ny.us/payroll/files/ac2772.pdf
2016 NYS IT2104 https://www.tax.ny.gov/pdf/current_forms/it/it2104_fill_in.pdf
2016 Federal W4 https://www.irs.gov/pub/irs-pdf/fw4.pdf
Federal I9 https://www.uscis.gov/sites/default/files/files/form/i-9.pdf
Waiver of Additional Money for Holiday Work Holiday Comp Waiver
Overtime
Overtime Form OT Form
Lease Overtime Form Lease OT Form
FMLA
Certification of Health Care Provider for Employee’s Serious Health Condition
http://dmna.ny.gov/state/files/WH-380-E.pdf
Certification of Health Care Provider for Family Member’s Serious Health Condition
http://dmna.ny.gov/state/files/WH-380-F.pdf
Notification of Eligibility and Rights & Responsibilities
http://dmna.ny.gov/state/files/WH-381.pdf
Designation Notice http://dmna.ny.gov/state/files/WH-382.pdf
Certification of Qualifying Leave for Military Family Leave
http://dmna.ny.gov/state/files/WH-384.pdf
Certification for Serious Injury or Illness of Covered Service member--For Family Medical Leave
http://dmna.ny.gov/state/files/WH-385.pdf
ADA
For questions or assistance with ADA procedures, please contact the agency ADA Coordinator, Mrs. Tina Lehning or Assistant Human Resources Director, Mrs. Laurie Romer at (518) 786-4830.
ADA Reasonable Accommodation Procedures http://dmna.ny.gov/state/files/MNHS_Bulletin_2014-04_-_ADA_Reasonable_Accommodation_Procedures.PDF
ADA Reasonable Accommodation Request Form http://dmna.ny.gov/state/files/Request_for_Reasonable_Accommodation-Form_DMNA6.pdf
Reasonable Accommodation Procedures - Public
http://dmna.ny.gov/state/files/Reasonable_Accommodation_(Public).pdf
Reasonable Accommodation Procedures - Disability
http://dmna.ny.gov/state/files/Reasonable_Accommodation_(Disability).pdf
Reasonable Accommodation Procedures - Religion
http://dmna.ny.gov/state/files/Reasonable_Accommodation_(Religion).pdf
Performance Evaluations
Probationary Status Reports
Administrative, Armory, O&M DMNA 1033
Firefighter DMNA 1034
Security DMNA 1035
Workplace Violence Report
Incident Report Form http://dmna.ny.gov/state/files/DMNA27_20150123.pdf
Discrimination Complaint Form
/state/files/1499978454--DMNA_Discrimination_Complaint_Form_fillable.pdf
