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 was developed to assist supervisors/senior staff members in requests for new positions, fill vacancies, promotions, salary increases, change in status, etc. PAR Forms must be submitted no later than two days prior to the next meeting date. For planning purposes, please note the upcoming Position Review Team meetings for 2019: January 29th, February 11th, March 6th, April 17th, May 10th, May 29th.

Performance Management

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

Flexible Benefit System FSA Health/Dependent Claim 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

Computer Purchasing Plan Forms
Guidelines and necessary forms.

Emergency Contact Information Form
Information to be used to contact in case of emergency.

New Employee Hire Forms

Employment Eligibility
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. Please review the I-9 List of Eligible Documents below.

I-9 List of Eligible Documents (PDF)
This list provides the approved documents that may be used to complete the I-9 form.

NYS IT-2104 (PDF)
This form is the US Employee's Withholding Allowance Certificate - it is the federal 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.

Payroll Forms

Direct Deposit (PDF)
Use this form to add, change, or cancel your direct deposit. You may have two direct deposit designations at one time. All changes can be made by following this guide.

Exempt Administrative Salaried/Exempt Time Report (PDF) - Fill in online!
For all full-time exempt administrative employees. This form is used to report days off from work (vacation, sick, holidays, etc.).

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

Full Time Hourly Timesheet (PDF) - Fill in online!
For all full-time, benefits-eligible, hourly-paid employees.

Non-Exempt Administrative Timesheet (PDF) - Fill in online!
For all full-time non-exempt administrative employees. This form is used to report hours worked, vacation, sick, holidays, etc.

Part Time Hourly Timesheet (PDF) - Fill in online!
For all part-time, non-benefits, hourly-paid employees.

Retirement Forms

Salary Reduction Agreement Form (Word)
This form is used by employees who wish to enroll in the Colleges 403(b) plan and/or the supplemental 403(b)(7) plans. This form is also used to change the amount of payroll contributions.

Designation of Beneficiary
This form is used to designate who shall receive the value of the employee's TIAA-CREF GRA and/or GSRA accumulation in the event of their death prior to retirement. Some beneficiary information can be entered online. Please visit the WebCenter at for information.

Vanguard - Enrollment Kit
This link will give you immediate access to the Vanguard 403(b)(7) employee enrollment kit - download the forms or have them mail you a kit!

Tuition Benefit Forms

Tuition Exchange (PDF)
For the employee's dependent child. This form must be submitted to Human Resources twelve months prior to the start of the academic year that is to be considered. Questions of eligibility must be addressed with the Office of Human Resources. Also, a list of potential exchange schools must be submitted to the Financial Aid Office in order to reserve a potential tuition exchange scholarship at the desired schools.

Tuition Grant (PDF)
For employee's dependent child. This form must be submitted to Human Resources prior to the academic year to be considered. If tuition due is divided into two payments (fall and spring), a new form for the second semester is not necessary - submit the second semester's invoice to Human Resources for payment. Must be received by noon, Tuesday, for a check on that Friday.

Tuition Reimbursement (PDF)
For reimbursement of tuition costs for any course or courses taken by the employee in order to complete a first undergraduate degree. Individual courses that are not required as part of a degree program must be job-related in order to qualify for reimbursement. In either case, approval is required prior to registration for the course(s).

Tuition Remission (PDF)
For employee/spouse or domestic partner/dependent child who attends Hobart and William Smith Colleges. This form must be submitted to Human Resources prior to the academic year/semester to be considered.



If you have problems completing, printing or viewing any of these forms, please contact the Associate Director of Human Resources Peggy Ferran.


Preparing Students to Lead Lives of Consequence.