Herkimer County
 Departments 

Forms

Table Of Contents:
Description:

Absence Report (monthly)

Additional Position Request Form 

AFLAC Cancellation 

Antiharassment 

Application Fee Waiver

Breast Cancer Screening Release 

Change of Address Form for Exams

Code of Ethics 

CSC-20 211 Employ Retired Public Employee

Family Medical Leave Act Application  

HCCC Fitness Application

I-9 Employment Eligibility Verification

Incident Report - BLUE paper only 

Job Classification Questionnaire 

MSD 220 Job Classification Questionnaire Form 

MSD 222 New Position Duties Statement

MSD 330 Application 

MSD 332 VC 1 Veterans' Application Form

MSD 390 (Veterans') Disability Record Authorization

Notice to Information Services NEW/CHANGE in Employee

Notice to Information Services TERMINATIONS 

Payroll Certification

Payroll Form - Hourly Paid Employees

Payroll Form - Salaried Employees

Physical Examination 2 pages 

Prostate Cancer Screening Release

Report of Personnel Change - PINK paper only 

Request for Additional Position

Section 211 Request to Employ Retired Public Employee -- use LINK to NYS Retirement System 

Sick Leave Bank Application

Veterans' Credit Information Sheet