"NEW EMPLOYEE ORIENTATION CHECKLIST AND"
FORM RFGI-2 DIVISION OF RESEARCH PERSONNEL AND PAYROLL State University of New York at Binghamton NEW EMPLOYEE ORIENTATION CHECKLIST AND CERTIFICATION OF RECEIPT As a Research Foundation employee, you are entitled to receive information regarding your employment. This information is included on the following checklist and will be provided to you upon hire or as part of your employee orientation program. After reviewing the information that has been checked, please sign and date the certification of receipt statement. A copy will be given to you for your records. To Be Given To All Employees: To Be Given To All Employees Eligible for Benefits: Appointment Letter Optional Retirement Packets Employee Assignment Form Benefits Handbook (including addenda) Employment Eligibility Verification Form (I-9) Regular Employee Summary of Fringe Benefits Payment Method Form Benefits Enrollment Form IRS Employee's Withholding Allowance Certificate Benefits Enrollment Form Instructions (W-4) Prescription Drug Programs Information (brochure, NYS Certificate of Exemption from Withholding order envelope, order form) (IT 2104E) (when applicable) Enrollment Kit for the RF's Health Insurance Plan NYS Employee's Withholding Allowance Certificate HMO Materials (IT 2104) Consumer's Medical Resource Brochure Request for Retirement Credit Based on Prior NCQA Health Portal Description Non-SUNY Employment (when applicable) Group Long Term Care Brochure Request for Retirement Credit Based on Prior SUNY Dental Brochure Service (when applicable) Vision Brochure Employee Handbook Life Insurance Enrollment Kit Employee Work Schedule Information (as provided by To Be Given to Salaried Employees Only (with Regular, supervisor) Biweekly pay) in Addition to the Material Above: Bloodborne Pathogens Notice (when applicable to location or position) Flexible Spending Accounts Handbook Statement of Policy on Equal Employment Opportunity Voluntary Short Term Disability Kit Policy on Employment of Disabled Individuals Optional Information for All Employees: Policy on the Employment of Special Disabled and Vietnam Era, and Other Protected Veterans Educational Assistance Policy Policy on Nondiscrimination on the Basis of Age Campus or Operating Location's Smoking Policy Policy on Nondiscrimination on the Basis of Sexual Employee Assistance Program (EAP) Information Orientation Savings Bond Enrollment Card Statement of Policy on Sexual Harassment Check Distribution Information Procedure for Resolving Allegations of Discrimination Campus Holiday Schedule Procedure for Solving Problems in the Workplace Payment Method Additional Direct Deposit Information Conflict of Interest Policy Statement To Be Given To Graduate Student Employees Eligible for Drug-Free Workplace Policy Statement Patent Policy Statement Benefits: SUNY Computer Software Policy Statement Graduate Student Employee Health Plan (GSEHP) Patent Waiver and Release Agreement Enrollment Form Qualified Transportation Benefits Program Information and Graduate Student Employee Health Plan (GSEHP) Member Waiver of Pretax Parking Deduction Handbook New York's College Savings Program Brochure Graduate Student Dental Plan Brochure Notice of Privacy Practices Graduate Student Summary of Benefits Graduate Student Vision Care Booklet I certify that I have received a copy of the above-listed informational booklets and policy statements that provide details about my employment and benefits. _____________________________________________ _______________________ Employee Name Date Original - Personnel File Copy/Duplicate - Employee Rev. 12/5/05