Hobart and William Smith Colleges

HUMAN RESOURCES FORMS

Benefits Related Forms

Certification of Marriage or Domestic Partnership and Declaration of Dependents (Word)
This form must be completed if employee wishes to cover his or her spouse (domestic partner for medical only) and eligible dependents under the Colleges' benefit programs.

Disability/Workers Compensation Forms

Accident Report
This form is used to report accidents that occur on campus property.

Short Term Disability Claim Form (PDF)
This form is used to claim for statutory disability benefits for an extended absence (longer than 7 consecutive days) due to a non-work related illness or injury. Employee completes Part A-Claimant then has his/her attending physician to complete Part B before returning to Human Resources.

Reasonable Accommodations for Employees with Disabilities
To request an accommodation please complete the accommodation request form and return it to Human Resources.

Management Forms

Position Approval Request (PAR)
This form is to assist supervisors/senior staff members in requests for new positions, fill vacancies, promotions, salary increases, change in status, etc. Completed PAR Forms must be approved by your senior division lead and submitted no later than two days prior to the next meeting date.

Performance Management

• Core Capabilities
• Performance Appraisal Form

Youth Program Questionnaire
This form should be completed by any employee who oversees a youth program or activity sponsored by HWS, whether it takes place on campus or off campus.

Medical, Dental and Flexible Spending Account Claim Forms

FSA Handbook

LBS FSA Health Reimbursement Form
LBS FSA Dependent Care Reimbursement Form
*To view your FSA account online please see this flyer*

Dental Claim Form (PDF)
For the Guardian Dental plan.

Excellus Claim Form (PDF)

OptumRx Reimbursement Form (PDF)

Guardian Davis Vision Claim Form (PDF)

Guardian VSP Vision Claim Form (PDF)

Miscellaneous Forms

Faculty and Staff Gift Commitment Form - Payroll Deduction*
*To make your gift on a credit card please visit our secure online giving site at www.hws.edu/onlinegiving.

FMLA Forms:

Certification of Health Care Provider for Family Member's Serious Health Condition

Certification of Health Care Provider for Employee's Serious Health Condition

New Employee Hire Forms

Employment Eligibility
Information on employment eligibility and the I-9 form. The I-9 is required to be completed in the Human Resources Office on the employee's first day of work. Original documentation must also be presented at that time.

Form I-9
This form, known as the I-9, is required to be completed in the Human Resources Office on the employee's first day of work. Original documentation must also be presented at that time.

NYS IT-2104 (PDF)
This form is the US Employee's Withholding Allowance Certificate - it is the New York State tax withholding document.

W-4 Form (Federal Tax) (PDF)
This form is the US Employee's Withholding Allowance Certificate - it is the federal tax withholding document.

Retirement Forms

To enroll or change your Transamerica deferral, please refer to their website at www.trsretire.com.

Tuition Benefit Forms

Forms for Tuition Assistance Programs 

Tuition Exchange and Tuition Grant Procedure Guidelines (PDF)