Unemployment Insurance Form

As an employer, the university is required to notify certain employees and separated employees of their right to file for NYS unemployment benefits.

Print and Deliver to the Separating Employee

  1. Open the form for the employee's appointment type
  2. Add the date you are giving to the employee (within 5 days of the employee seperating)
  3. Print the form
  4. Give the employee the form
  5. Save a copy to the HR UB Box folder using the naming convention: Person Number - Last Name

Email to the Separating Employee

  1. Open the form for the employee's appointment type
  2. Add the date you are giving to the employee (within 5 days of the employee seperating)
  3. Send the form as an attachment to the employee
  4. Save a copy to the HR UB Box folder using the naming convention: Person Number - Last Name

Download the Form

For Research Foundation Employees

Research Foundation (RF) Unemployment Insurance Form

For State Employees

State Unemployment Insurance Form

For UB Foundation Activities Employees

UBF Activities Unemployment Insurance Form
Mobile Users

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Need Help Completing the Form?

ePTF Support

ePTF Support Staff

State Appointment Processing

Phone: 716-645-3783

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: November 2023