Dual Appointment or Extra Service Approval

Request for approval to serve with another state agency for dual appointment or extra service.

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  1. Read through all pages of the document to find specific instructions if any
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  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original, completed, signed form to:         

Human Resources
120 Crofts Hall
North Campus

Need help completing the form?

Send email, phone or submit a question

Dana Moore

Manager

State Appointment Processing

Phone: 716-645-8157

Email: dlmoore@buffalo.edu

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Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: March 3013

Owner: New York State Office of State Comptroller