Temporary Alternate Work Assignment Request

Faculty and staff may request a temporary alternate work assignment or location.

Download the Form

When you click the link to download the form, it may open in your web browser. It is recommended that you download and save the form in order to use the digital signature feature.

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Completing the PDF Form

  1. Enter requested information into the form
  2. Send to supervisor for review
  3. Get all required signatures
  4. Scan or save final approved document
  5. Rename your file to include: Your Last Name_Your First Name_Your Person Number (ex. Smith_John_22222222)
  6. Document should be submitted to the UB HR Benefits Secure Box Folder:

Need Help Completing the Form?

State Benefits

Human Resources

Phone: 716-645-7777

Email: ub-hr-benefits@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: 06/29/2021

Owner: Human Resources