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
2019 NYS IT2104 https://www.tax.ny.gov/pdf/current_forms/it/it2104_fill_in.pdf
2019 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 Bulletin - Overtime Bulletin
Overtime Form OT Form
Lease Overtime Form Lease OT Form
FMLA
Certification of Health Care Provider for Employee’s Serious Health Condition
/state/files/1549041075--WH-380-E.pdf
Certification of Health Care Provider for Family Member’s Serious Health Condition
/state/files/1549041094--WH-380-F.pdf
Notification of Eligibility and Rights & Responsibilities
/state/files/1549041109--WH-381.pdf
Designation Notice /state/files/1549041122--WH-382.pdf
Certification of Qualifying Leave for Military Family Leave
/state/files/1549041133--WH-384.pdf
Certification for Serious Injury or Illness of Covered Service member--For Family Medical Leave
/state/files/1549041144--WH-385.pdf
ADA
For questions or assistance with ADA procedures, please contact the agency ADA Coordinator, Mrs. Tina Lehning or Deputy 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
Reasonable Accommodation Procedures - Public
/state/files/1509545332--Reasonable_Accommodation_Public_2017.pdf
Reasonable Accommodation Procedures - Disability
/state/files/1509544974--Reasonable_Accommodation_Request_Form_(Disability)_2017.pdf
Reasonable Accommodation Procedures - Religion
/state/files/1509544941--Reasonable_Accommodation_Request_Form_(Religion)_2017.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
https://goer.ny.gov/new-york-state-discrimination-complaint-form
MNFE Forms and Resources
DMNA Form 47 - (Project Request Form) - /state/files/1507296697--DMNA_47_-_17_SEP_15.pdf
DMNA Form 95 - (Hand Receipt for Expendable or Non-Expendable Items) - /state/files/1507296722--DMNA95_(002).pdf
Business Service Center (BSC) Announcements
Website: https://bsc.ogs.ny.gov/
/state/files/1548794368--1548266355--Leave_for_Childbirth_Childcare_and_Adoption_Guidelines.pdf
