Salary differentials application form used by F/Z/O status and Adult Education teachers

Use this form to notify the UFT about a change of name, a change of address or a change of telephone number.

SHIP beneficiary form

This form is to be used to receive seniority credit for prior paraprofessional service by pedagogical personnel who have received a regular appointment.

Eligible DOE employees who choose not to participate in the Teacher's Choice Program must complete this form and submit it to the Teacher's Choice Unit at the DOE by the due date indicated .

This form is used to request a Market Rate increase if you serve only children receiving child care assistance.

Members currently on a leave may use this form to request an extenuating circumstance for missing the deadline to submit your intention for the next school year or to modify your intention due to a material change.

DOE media consent form for public schools

Teacher's Choice participants use this form to inform their school principal of purchases made with Teacher's Choice funds. Once completed, attach all original receipts/invoices and submit to your school principal for review.

Medicare Part B Income-Related Monthly Adjustment Amount (IRMAA) reimbursement form

Retiring members should complete this form if they are filing for retirement under the Qualified Pension Plan (QPP) and are Tax-Deferred Annuity (TDA) Program participants who want to defer distribution of their TDA funds past the date on which they...

Use this form to document a hazardous chemical exposure incident in your school. Parts I, II, and III of the form are included.

This form is used to request a Market Rate increase if you serve both children receiving child care assistance and children who do not receive child care assistance (private pay).

DOE media consent form for third party/nonprofit use

PD19 form for Leave of Absence with Pay for Administrative Employees - including nurses and therapists

Registered family and licensed group providers whose rates listed on file with ACS are not already higher than the 2007 market rate should use this form to apply to receive the new market rate moving forward and retroactively.

Use this form to request employment verification for pension purposes.

If you are filing for workers’ compensation, you must file these forms:

This form is for payroll secretaries.

Open enrollment health benefits change form for active DOE employees from NYC Office of Labor Relations

This form must be completed and submitted to the per session supervisor prior to commencement of employment in a per session activity. Waivers for per session activities that will exceed 400 hours must be submitted electronically through the DOE's...

Moving forward, all informal providers will receive the standard 2007 market rate without having to apply. In order to receive the 2007 rate retroactively, informal providers must apply for it and attest that their cost of care has increased. Please...

The DOE will reimburse you up to $500 per school year for stolen or destroyed property such as loss or damage to personal clothing and personal accessories. For reimbursement of eyeglasses damaged in assault cases, use form OP 505G.

This form for Lab Specialists is taken from the DOE Science Safety Manual.

All pedagogues and paraprofessionals may use this form to donate sick time to a colleague. The recipient receives one day for every two days donated. Sick leave transfer rules are on page 2 of the form.

Here is the form for an attending doctor to obtain medical authorization:

Last updated, 3/28/23

Complete this form to claim disability benefits only if your Workers’ Compensation claim has been rejected.

This form is used to transfer accrued per-session sick leave to the employee's regular cumulative absence reserve.

See instructions with screenshots to download and print your W-2 tax form from the DOE's NYCAPS Employee Self Service (ESS) platform.

Workers’ compensation intake form for Paraprofessionals, School Nurses, Occupational and Physical Therapists: