Forms for the use of Wagner College employees

Additional Pay Request Form - for use by a department to provide an employee with additional compensation beyond their normal regular pay, under identified and approved special circumstances and conditions.

Administrative Monthly Time Report — to report all exempt administrative employees benefit time on a monthly basis.

Declaration of Establishment Domestic Partnership— to establish the existence of a domestic partnership for the purpose of benefit eligibility.

Declaration of Termination of Domestic Partnership  — for canceling a previously filed Declaration of Domestic Partnership.

Employment Eligibility Verification (Form I-9) — As required by the Immigration Reform and Control Act of 1986, all new hires must fill out this form, also known as the I-9. The form is used to verify the eligibility of the individual for the employment in the United States.

Employee's Withholding Allowance Certificate (W-4) — to determine the correct income tax withholding.

FMLA Certification of Healthcare Provider — used by the medical provider of an employee filing for FMLA (Family Medical Leave Act) leave.

FSA Enrollment Form — to participate in the Flexible Spending Account program.

FSA Reimbursement — to be reimbursed under the Flexible Spending Account program.

NY Employee's Withholding Allowance Certificate (IT-2104)— to specify allowances for New York City, New York State and Yonkers income tax.

Part-Time Administrator Time Sheet

Payroll Direct Deposit Authorization — to request that your payroll check be deposited directly into your savings or checking account.

Position Request & Authorization Form - to request to recruit for a new position

Personal Data Form — used by the Human Resources Office to collect employees' personal data.

Transit Check Enrollment Form - pretax transit/commuter benefit (NYC Transit - MetroCard, MetroNorth, PATH Train, LIRR, etc)

Tuition Remission Form - for employees and/or dependents attending Wagner. (Must be completed each semester)


If you have any questions or concerns about any of the forms please contact the Office of Human Resources.