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University of Connecticut Department of Human Resources

Online 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.  

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
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) 
Affiliate NET ID Request Form
N/A
N/A
Alternative Work Schedule Selection Form (P-5)
PDF
WORD
Application for Employment
Husky Hire & Candidate Gateway
Bargaining Unit Change Form
PDF
Classified Request to Carry Over Vacation into 2013
PDF
Clerical Service Rating Form - Per 126 (NP-3)
PDF
WORD
Compensatory Time Accrual Request Form
PDF
WORD
Compensatory Time Payment Authorization Form
PDF
N/A
Conflict of Interest Disclosure Form
   
Domestic Partnership Affidavit
N/A
WORD
Dual Employment Form
PDF
Employee Information Sheet for Special Payroll
 
Employment Separation Form
PDF
WORD
Equal Employment Opportunity Information Sheet
 
Faculty Hiring Form
WORD
Faculty Leave Request Form (Use for all leaves other than Sabbatical Leave and Family/Medical Leave)
WORD
Faculty Research Certification
WORD
Flextime Schedule Selection Form (NP-3)
WORD
FMLA Request Forms
Checkbox
Furlough Day Record  
WORD
General Service Rating Form - Per 125 (NP-5, NP-6, P-4)
PDF
WORD
Genesys and Focus Access Request Form
N/A
WORD
Health Insurance Qualifying Status Change Form
PDF
I-9 Form
PDF
N/A
Job Change Questionnaire for Non-Teaching Professionals
PDF
WORD
Longevity
PDF
WORD
Maintenance Service Rating Form - Per 148 (NP-2)
PDF
WORD
Medical Certificate
   
Checkbox
Military Leave Request Form
PDF
Moving Expense Reimbursement Form
PDF
NP-2 Seniority Waiver Form  
WORD
NP-3 Employee Request to Rearrange Work Schedule
 
(NP-3) Administrative Clerical Bargaining Unit - UCONN Geographic Transfer List Request
PDF
Personal Change Form

PDF

N/A
Personal/Emergency Leave without Pay Form
 
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
Reclassification Request for Research Assistant/Research Associate/Academic Assistant
PDF
WORD
Report Request Form
Report Request Form
Request for Schedule Modification (P-5)
PDF
WORD
Resignation Form
PDF
WORD
Sabbatical Leave Request Form
N/A
 
Sabbatical Modification Form
N/A
 
SEBAC Rights for UCPEA End Date Nonrenewals
Separation Form
PDF
WORD
Social and Human Services Rating Form (P-2)
PDF
WORD
Special Payroll Authorization
PDF
EXCEL
Special Payroll Disclosure Form
PDF
 
Temporary Flexible Schedule Request for Managerial/Confidential Employees
PDF
WORD
Temporary Flexible Schedule Request for UCPEA Employees
PDF
N/A
UCP End--Date and Temporary Position Request Form
PDF
   
UCPEA Internship Request Form
N/A
Voluntary Schedule Reduction Program Application
PDF
Waiver of Union Representation Form
PDF
WORD
Worker's Compensation Filing Status and Exemption Form
N/A
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