Employee Statement in Lieu of Oath for State

State employee pledge to support the constitution of the United States and State of New York pursuant to Civil Services Law #62.

Agency Name:
SUNY at Buffalo

Agency Code: 
Faculty and Staff use 28030
Teaching and Graduate Assistants  use 28039

Information You Will Need to Complete the Form

Completing the PDF Form

  1. Read through all pages of the document to find specific instructions, if any
  2. Enter requested information into the form
  3. Print the form
  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
University at Buffalo
Townsend Hall
205 Hayes Road
Buffalo, NY 14214

Need Help Completing the Form?

Angela Kuc.

Angela Kuc


State Appointment Processing & Payroll Services

Phone: 716-645-4427

Email: akuc@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: September 2022

Owner: Human Resources