DHR Forms and Personnel Memoranda

Personnel Memoranda:

On-Boarding:

Conditional Offer of Employment Medical Form

WEP Request Form

Chapter 68: Conflict of Interest Form

Pamphlet COIB-DOE

OP-4444 - Employment Relationship with Family

Disclosure of Misconduct Form

Rules and Regulations Governing Administrative Employees

Designation of Beneficiary
This Designation of Beneficiary form applies only to H/Z bank Administrative Employees such as Clerical Associate, Principal Administrative Associate, Computer Associate, Administrative Education Analyst, etc. Completed forms should be submitted to the Administrative Employees Unit, Room 501, 65 Court Street, Brooklyn, NY 11201, any time there is a change to beneficiary information in relation to annual leave accruals. This form does NOT apply to pedagogues such as Teachers, Guidance Counselors, etc. or to School Aides, Family Workers or UFT Paraprofessionals.

Pre-Employment Background Checks:

OSPRA 103
When submitting the OSPRA 103, the Fingerprint Referral Form and I-9 Form are also required, including a clear copy of each acceptable document that is used to show eligibility to work in the United States. Please note: Once the OSPRA 103 has been submitted and entered, additional fingerprinting at 65 Court Street for the person who submitted the OSPRA 103 is prohibited.

OSPRA 104

Fingerprint Referral Form

Employment Eligibility Verification (I-9) form

Personal and Tax Data Changes:

Personal and Tax Data Change form
The Personal and Tax Data Change form replaces the formerly used OP-85 form. Make sure to use this form to make any necessary tax and data changes.

W4

IT-2104

IT-2104E

Withholding Certificate Affirmation

Payroll and Direct Deposit:

New York City Office of Payroll Administration

Visit the Division of Financial Operations' Direct Deposit Web page for more information.

Stop Payment Form
NOTE: For use by payroll secretaries and timekeepers only.

T-Bank Stop Payment Request Form
NOTE: For use by payroll secretaries and timekeepers only.

Salary Services:

Salary Upgrade Form for Educational (UFT) and Family (DC37) Paras

Commencement of Service Form

Restoration Form

Reversion Form

Employment Verification:

Employment Verification Request Form

Visit the employment verification Web page for more information about the use of this form and to find related online forms.

Professional Development:

Summer Stipend Application

Bilingual Pupil Services applications are submitted online. Click for more information about the Bilingual Pupil Services program.

Supervising School Aide:
The Division of Human Resources & Talent will offer a professional development opportunity ensuring eligibility and leading to the qualification for the position of supervising school aide. Click to access information about the hiring process, as well as to access the registration form.

Recruitment and Selection:

Substitute Teacher Application:
The New York City Department of Education is now accepting applications for new substitute teachers only from individuals with a principal’s online nomination. Once the principal has entered an online nomination for the candidate, the substitute nominee will be e-mailed information on how to access and complete the online application. For more information about becoming a substitute teacher, please visit http://schools.nyc.gov/Offices/DHR/SubTeachers.

Certification and Credentialing:

Applications to become a teacher are submitted electronically at http://www.teachnyc.net/.

Lab Specialist Exam Announcement (Fall 2007)

Click to access the DOE Road to Certification Workshop Application on the Teach NYC Web site.

Various school, district and regional based positions require New York State certification. New York State certification is obtained through the New York State Education Department (NYSED).

Visit the NYSED Web site for additional information regarding certification.

175 Professional Development Tracking Form
This form is used by NYSED "Professional" certificate holders to submit their completed professional development hours to the Office of Certification and Licensing.

Scholarships and Special Programs:

School-Based Option Submission Form

Incentives and Discounts:

Verizon Employee Enrollment Form

Expanded TransitBenefit Program with WageWorks

Separation of Service:

Authorization for Release of Information

Commencement of Service:

Application for Withdrawal of Resignation/Retirement

Commencement of Service Form