UNIVERSITY OF CONNECTICUT
DEPARTMENT OF HUMAN RESOURCES

FORMS

Statements Regarding Collection of Social Security Numbers on Forms

SSN required on University employment forms:

Federal tax regulations require the University of Connecticut Department of Human Resources to collect a social security number (SSN) from every employee who is paid compensation.  Employee SSN’s are maintained and used by the University for payroll and benefits purposes, to verify employment history, and where required by law or for benefits purposes, to report the employee’s SSN on Federal and state agency forms.  Except as mandated by law or as required for benefit purposes, the University will not disclose an employee's SSN to any person or organization outside the University without the employee’s prior consent.  Failure to provide a SSN to the University of Connecticut on required Human Resources forms may result in the withdrawal of an offer of employment and/or the denial of benefits.  For more information on the use of SSN’s at the University of Connecticut, please visit http://www.ssn.uconn.edu.

SSN required by third party form (such as benefit form):

At times the University of Connecticut may provide University employees with forms on behalf of benefit providers and other organizations.  Many of these forms require you to provide your social security number (SSN). As private companies it is within their rights to require you to provide your SSN in order to provide the requested service. These services typically include but are not limited to health and life insurance, retirement benefits, and employment verification.  In addition, many State and Federal forms will also request your SSN.  These forms may include, but are not limited to:  tax and other compensation-related forms, background check forms for security sensitive positions, immigration forms, and forms for other government services.  If you feel one of these third parties has misused your SSN, your first recourse is to contact the third party directly.

FORM NAME

PDF FORMAT

WORD FORMAT
 MORE INFO
Accident Report (see First Report of Occupational Injury or Disease
Acknowledgement of Temporary Appointment
 PDF
WORD
Administrative and Residual Service Rating Form - Per 127 (P-5)
PDF
WORD
Address and Name Change Form (See Personal Change Form)

 

 

Address and Name Change Form (GRAD STUDENTS CLICK HERE) 

 

 

Advance of Sick Leave - Classified Staff
PDF
WORD
Advertising Estimate/Authorization Form
PDF
WORD
More Info
Affiliate NET ID Request Form
N/A
WORD
Alternative Work Schedule Selection Form (P-5)
PDF
WORD
American Red Cross Volunteer - Request for Governor's Paid Leave
PDF
WORD
American Red Cross Volunteer - Consent Form
PDF
WORD
Application for Employment
PDF
N/A
Bargaining Unit Change Form PDF
Budget Certification for Employment Form
PDF
WORD
More Info
Classified Search Report
PDF
WORD
Classified Staff Recruitment - AAP-2 Card
PDF
WORD
Clerical Service Rating Form - Per 126 (NP-3)
PDF
WORD
Collective Bargaining Unit Change Form PDF
Compensatory Time Accrual Request Form
PDF
N/A
Compensatory Time Payment Authorization Form
PDF
N/A
Domestic Partnership Affidavit
N/A
WORD
Dual Employment Form
N/A
WORD
Employment Separation Form
PDF
WORD
More Info
Essential Staffing Request for Academic Affairs
N/A
 
Faculty Leave Request Form (Use for all leaves other than Sabbatical Leave and Family/Medical Leave)
WORD
Faculty Summer Research Certification
PDF
WORD
Family and Medical Leave Form for Faculty and Coaches PDF  
First Report of Occupational Injury or Disease
PDF
N/A
Flextime Schedule Selection Form (NP-3)
PDF
WORD
General Service Rating Form - Per 125 (NP-5, NP-6, P-2, P-4)
PDF
WORD
Genesys and Focus Access Request Form
N/A
WORD
I-9 Form
PDF
N/A
Job Change Questionnaire for Non-Teaching Professionals
PDF
WORD
Leave Without Pay - Classified Employees
PDF
WORD
Longevity
PDF
WORD
Maintenance Service Rating Form - Per 148 (NP-2)
PDF
WORD
Maternity Leave Form - Classified
N/A
Maternity Leave Form for UCPEA Members
PDF
WORD
Medical and Dental Change Forms
PDF
N/A
Military Leave Request Form
PDF
WORD
Moving Expense Reimbursement Form
PDF
WORD
More Info
NP-2 Seniority Waiver
PDF
WORD
NP-3 Employee Request to Rearrange Work Schedule
PDF
WORD
Personal Change Form

PDF

N/A
Privacy Code Change Form
PDF
N/A
Professional Paid Advertising Supplement
PDF
WORD
Professional Staff Evaluation Form
PDF
WORD
Professional Staff University Merit Form
PDF
WORD
Reclassification Request for Research Assistant/Research Associate/Academic Assistant
PDF
WORD
Recommendation for Joint Appointment
PDF
WORD
Report Request Form
N/A
WORD
Request for Schedule Modification (P-5)
PDF
WORD
Request for Unpaid FMLA – UCPEA/Managerial-Confidential Exempt

Request to Carry Over Vacation into 2008
N/A
WORD
Resignation Form
PDF
WORD
More Info
Sabbatical Leave Request Form
N/A
 
Sabbatical Modification Form
N/A
 
Sick Leave Request (unclassified staff)
N/A
WORD
SEBAC Rights for UCPEA End Date Nonrenewals
HTML
HTML
Separation Form
PDF
WORD
More Info
Special Payroll Authorization
PDF
EXCEL
More Info
Special Payroll Employee Information Sheet
PDF
WORD
Special Payroll Request for Waiver of Time or Earnings
PDF
WORD
Statement of Claim for Unpaid Wages
N/A
Summer research certification - faculty
PDF
WORD
Temporary Flexible Schedule Request for Managerial/Confidential Employees
PDF
WORD
UCPEA Internship Request Form
N/A
Temporary Flexible Schedule Request for UCPEA Employees
PDF
N/A
Voluntary Leave & Schedule Reduction Form
PDF
N/A
More Info
Waiver of Union Representation Form
PDF
N/A
Worker's Compensation Filing Status and Exemption Form
PDF
N/A

Blue Bar

University of Connecticut
Department of Human Resources
Comments to: HR Webmaster