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Title	Documents & Links	Revision Date
1000 FR.01 Policy Proposal	1000 FR.01 Policy Proposal	January 12, 2018
1001 FR.01 Request for Provostial Pre-Approval for Faculty Extra Compensation	1001 FR.01 Request for Provostial Pre-Approval for Faculty Extra Compensation 1001 FR.01 Instructions - Request for Provostial Pre-Approval for Faculty Extra Compensation	March 29, 2018
1101 FR.01 Financial Review Checklist	1101 FR.01 Financial Review Checklist	February 16, 2021
1101 FR.02 Manual Journal Entry Request	1101 FR.02 Manual Journal Entry Request	June 20, 2017
1107 FR.01 Reporting Template for Foreign Gifts and Contracts	1107 FR.01 Reporting Template for Foreign Gifts and Contracts	October 27, 2020
1110 FR.01 Personal Use of University Vehicles - Department Summary Sheet	1110FR.01 Personal Use of University Vehicles - Department Summary Sheet .pdf 1110FR.01 Personal Use of University Vehicles - Department Summary Sheet .xls	November 11, 2015
1110 FR.02 Personal Use of University Vehicles - Questionnaire	1110FR.02 Personal Use of University Vehicles - Questionnaire .pdf 1110FR.02 Personal Use of University Vehicles - Questionnaire .xls	November 11, 2015
1110 FR.03 Mileage Record	1110 FR.03 Mileage Record	January 15, 2021
1300 FR.01 COA - Yale Designated Forms	1300 FR.01 COA - Yale Designated Forms	May 22, 2017
1300 FR.02 COA - Cost Center Forms	1300 FR.02 COA - Cost Center Forms	May 22, 2017
1300 FR.03 COA - Program Forms	1300 FR.03 COA - Program Forms	May 22, 2017
1300 FR.04 COA - Project Forms	1300 FR.04 COA - Project Forms	May 22, 2017
1300 FR.05 COA - Assignee Forms	1300 FR.05 COA - Assignee Forms	May 22, 2017
1301 FR.01 Request to Transfer Residual Balance from Sponsored Awards	1301 FR.01 Request to Transfer Residual Balance from Sponsored Awards	October 25, 2017
1304 FR.01 Pre-Award Costs and At-Risk Account Request Form	1304 FR.01 Pre-Award Costs and At-Risk Account Request Form 1304 FR.01 Pre-Award Costs and At-Risk Account Request Form - Instructions	March 10, 2021
1304 FR.03 Transmittal Summary (Tran Sum) Form	1304 FR.03 Transmittal Summary (Tran Sum) Form	April 9, 2020
1304 FR.03A Subrecipient Information and Compliance Form	1304 FR.03A Subrecipient Information and Compliance Form	May 6, 2020
1304 FR.03C National Research Service Award ("NRSA") Assurance of Compliance	1304 FR.03C National Research Service Award ("NRSA") Assurance of Compliance	February 28, 2020
1304 FR.04 Award Budget Setup ("ABS") Form	1304 FR.04 Award Budget Setup ("ABS") Form 1304 FR.04 Award Budget Setup ("ABS") Form - Upload Instructions	April 27, 2020
1304 FR.06 Responsible Personnel Change Form	1304 FR.06 Responsible Personnel Change Form	June 8, 2017
1304 FR.09 Cost Allocation Methodology	1304 FR.09 Cost Allocation Methodology 1304 FR.09 Cost Allocation Methodology - Instructions	January 14, 2021
1305 FR.15 Manual Journal-Cost Transfer Justification	1305 FR.15 Manual Journal - Cost Transfer Justification	March 5, 2019
1305 FR.17 GSPS Cost Transfer	1305 FR.17 GSPS Cost Transfer	March 5, 2019
1306 FR.01 Cost Sharing Approval Request	1306 FR.01 Cost Sharing Approval Request 1306 FR.01 Cost Sharing Approval Request - Instructions	April 4, 2018
1307 FR.01 Request for Subrecipient Prepayment	1307 FR.01 Request for Subrecipient Prepayment	May 4, 2018
1310 FR.04 PI Status Request Form	1310 FR.04 PI Status Request 1310 FR.04 PI Status Request - Instructions	June 28, 2018
1310 FR.05 Delegation of Requestor Authority for Sponsored Projects	1310 FR.05 Delegation of Requestor Authority for Sponsored Projects	February 27, 2019
1310 FR.06 Delegation of Approval Authority for Sponsored Projects	1310 FR.06 Delegation of Approval Authority for Sponsored Projects	May 4, 2018
1315 FR.01 Effort Report	1315 FR.01A Effort Report - Short Form (8 Grants or Fewer) 1315 FR.01B Effort Report - Long Form (9 Grants or More) 1315 FR.01 Effort Report - Instructions	March 11, 2020
1403 FR.02 Justification to Direct Charge F&A Type Costs to a Federal Award	1403 FR.02 Justification to Direct Charge F&A Type Costs to a Federal Award	October 15, 2019
1410 FR.01 University Service Providers: Registration Form	1410 FR.01 University Service Providers: Registration Form	June 8, 2020
1410 FR.02 University Service Providers: Rate Calculation Worksheet	1410 FR.02 University Service Providers: Rate Calculation Worksheet - USE FOR FY22 1410 FR.02 University Service Providers: Rate Calculation Worksheet - USE FOR FY21 1410 FR.02A Lead Administrator Certification Page	March 4, 2021
1410 FR.04 Lockshop Key Request	1410 FR.04 Lockshop Key Request	June 20, 2017
1411 FR.01 Memorandum of Understanding	1411 FR.01 Memorandum of Understanding.xls	February 26, 2016
1430 FR.01 Shipping Policy Exception Request Form	1430 FR.01 Shipping Policy Exception Request Form	January 14, 2020
1601 FR.01 VPN Access Exception Request	VPN Access Exception Request Link	July 27, 2018
1601 FR.02 Identity and Access Management (IAM)	1601 FR.02 Identity and Access Management (IAM) - Appendix A: Data Groupings 1601 FR.02 Identity and Access Management (IAM) - Appendix B: Affiliations and Suppression Rules 1601 FR.02 Identity and Access Management (IAM)	September 4, 2020
1601 FR.05 Workday Matrix Organization Creation	1601 FR.05 Workday Matrix Organization Creation Request Form	May 15, 2017
1601 FR.06 Workday Supervisory Organization Creation	1601 FR.06 Workday Supervisory Organization Creation Request Form	June 22, 2017
1601 FR.07 Workday Supervisory Organization Change	1601 FR.07 Workday Supervisory Organization Change Request Form	June 22, 2017
1601 FR.08 Workday Reorganization Request	1601 FR.08 Workday Reorganization Request Form	May 15, 2017
1800 FR.01 Yale Central Space Request	1800 FR.01 Yale Central Space Request	August 28, 2018
1800 FR.02 Yale Medicine Clinical Space Request	1800 FR.02 Yale Medicine Clinical Space Request	August 28, 2018
1800 FR.03 Yale School of Medicine Research/Administrative Space Request	1800 FR.03 Yale School of Medicine Research/Administrative Space Request	October 1, 2018
1800 FR.04 Yale Residential Rental Request	1800 FR.04 Yale Residential Rental Request	May 4, 2018
2015 Form 1040A Example A	2015 Form 1040A Ex A
2015 Form 1040A Example B	2015 Form 1040A Ex B.pdf
2015 Form 1040A Example C	2015 Form 1040A Ex C.pdf
2015 Form 1040A Example D	2015 Form 1040A Ex D.pdf
2015 Form 1040A Example E	2015 Form 1040A Ex E.pdf
2015 Form 1040A Example F	2015 Form 1040A Ex F.pdf
2015 Form CT-1040 Example A	2015 Form CT-1040 EX A.pdf
2015 Form CT-1040 Example B	2015 Form CT-1040 Ex B.pdf
2015 Form CT-1040 Example C	2015 Form CT-1040 Ex C.pdf
2015 Form CT-1040 Example D	2015 Form CT-1040 Ex D.pdf
2015 Form CT-1040 Example E	2015 Form CT-1040 Ex E.pdf
2015 Form CT-1040 Example F	2015 Form CT-1040 Ex F.pdf
2016 Form 1040ES Example A	2016 Form 1040ES Ex A.pdf
2016 Form 1040ES Example B	2016 Form 1040ES Ex B.pdf
2016 Form 1040ES Example C	2016 Form 1040ES Ex C.pdf
2016 Form 1040ES Example D	2016 Form 1040ES Ex D.pdf
2016 Form 1040ES Example E	2016 Form 1040ES Ex E.pdf
2016 Form 1040ES Example F	2016 Form 1040ES Ex F.pdf
2016 Form CT-1040ES Example A	2016 Form CT-1040ES Ex A.pdf
2016 Form CT-1040ES Example B	2016_form_ct-1040es_ex_b.pdf
2016 Form CT-1040ES Example C	2016 Form CT-1040ES Ex C.pdf
2016 Form CT-1040ES Example D	2016 Form CT-1040ES Ex D.pdf
2016 Form CT-1040ES Example E	2016 Form CT-1040ES Ex E.pdf
2016 Form CT-1040ES Example F	2016 Form CT-1040ES Ex F.pdf
2100 FR.01 External Sales Approval Request - Short Form	2100 FR.01 External Sales Approval Request - Short Form	January 9, 2019
2100 FR.02 External Sales Approval Request - Standard Form	2100 FR.02 External Sales Approval Request - Standard Form	January 9, 2019
2100 FR.03 External Sales Annual Reapproval Form	2100 FR.03 External Sales Annual Reapproval Form	January 9, 2019
2100 FR.04 External Sales Compliance Checklist	2100 FR.04 External Sales Compliance Checklist	January 9, 2019
2200 FR.01 Donee Information Return (IRS Form 8282)	2200 FR.01 Donee Information Return (IRS Form 8282)	April 26, 2017
2200 FR.02 Noncash Charitable Contributions (IRS Form 8283)	2200 FR.02 Noncash Charitable Contributions (IRS Form 8283)	April 26, 2017
2203 FR.03 Request to Reinvest Unspent Endowment Income to Principal	2203 FR.03 Request to Reinvest Unspent Endowment Income to Principal	September 29, 2020
2203 FR.04 Request to Set-Up or Add to a University Fund Functioning as Endowment (UFFE)	2203 FR.04 Request to Set-Up or Add to a University Fund Functioning as Endowment (UFFE)	September 29, 2020
2203 FR.05 Request to Decapitalize an Existing University Fund Functioning as Endowment (UFFE)	2203 FR.05 Request to Decapitalize an Existing University Fund Functioning as Endowment (UFFE)	July 17, 2019
2203 FR.06 Request to Close Spendable Gift	2203 FR.06 Request to Close Spendable Gift	November 5, 2019
2203 FR.07 YSM - Request to Reinvest Unspent Endowment Income to Principal	2203 FR.07 YSM - Request to Reinvest Unspent Endowment Income to Principal	September 29, 2020
2203 FR.08 YSM - Request to Set-Up or Add to a University Fund Functioning as Endowment (UFFE)	2203 FR.08 YSM - Request to Set-Up or Add to a University Fund Functioning as Endowment (UFFE)	November 5, 2019
2203 FR.09 YSM - Request to Decapitalize an Existing University Fund Functioning as Endowment (UFFE)	2203 FR.09 YSM - Request to Decapitalize an Existing University Fund Functioning as Endowment (UFFE)	November 5, 2019
2203 FR.10 Request to Set Up a New Gift	2203 FR.10 Request to Set Up a New Gift	July 2, 2017
2801 FR.02 Money Transfer Form	2801 FR.02 Money Transfer Form	June 22, 2017
2805 FR.01 Cash Sale Worksheet	2805 FR.01 Cash Sale Worksheet	June 22, 2017
2810 FR.01 Sales Tax Report	2810 FR.01 Sales Tax Report	November 8, 2019
2815 FR.01 Petty Cash Voucher	2815 FR.01 Petty Cash Voucher [TCN]	June 22, 2017
2815 FR.02 Petty Cash Quick Voucher	2815 FR.02 Petty Cash Quick Voucher [TCN]	June 22, 2017
2815 FR.03 Petty Cash Fund Request	2815 FR.03 Petty Cash Fund Request 2815 FR.03 Petty Cash Fund Request - Instructions	June 22, 2017
2815 FR.04 Petty Cash Replenishment	2815 FR.04 Petty Cash Replenishment Form 2815 FR.04 Petty Cash Replenishment Form - Instructions [TCN]	June 22, 2017
3201 FR.04 Independent Cost Estimate	3201 FR.04 Independent Cost Estimate	October 2, 2020
3201 FR.05 Pricing Documentation (Comparative Pricing & Competitive Bidding)	3201 FR.05 Pricing Documentation (Comparative Pricing & Competitive Bidding)	July 29, 2019
3201 FR.06 Sole Source Documentation	3201 FR.06 Sole Source Documentation	July 29, 2019
3205 FR.04 Application for IRS Individual Taxpayer Identification Number (IRS Form W-7)	3205 FR.04 (IRS Form W-7) Application for IRS Individual Taxpayer Identification Number	May 31, 2017
3205 FR.05 Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting (Individuals)(IRS Form W-8BEN)	3205 FR.05 (IRS Form W-8BEN) Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding (Individual)	May 31, 2017
3205 FR.05A Certificate of Status of Beneficial Owner for United States Tax Withholding and Reporting (Entities)(IRS Form W-8BEN-E)	3205 FR.05A (IRS Form W-8BEN-E) Certificate of Status of Beneficial Owner for United States Tax Withholding (Entities)	May 31, 2017
3205 FR.06 Request for Taxpayer Identification Number and Certification (IRS Form W-9)	3205 FR.06 (IRS Form W-9) Request for Taxpayer Identification Number and Certification	May 31, 2017
3205 FR.07 Application for a Social Security Card (SSA Form SS-5)	3205 FR.07 (SSA Form SS-5) Application for a Social Security Card	May 31, 2017
3205 FR.09 Supplier Change Request	3205 FR.09 Supplier Change Request	July 1, 2020
3210 FR.01 Professional Services and Consulting Agreement	3210 FR.01 Professional Services and Consulting Agreement	June 14, 2018
3210 FR.02 Guest Speaker Agreement	3210 FR.02 Guest Speaker Agreement	December 21, 2020
3210 FR.04 Standard Performance Agreement	3210 FR.04 Standard Performance Agreement	September 23, 2020
3210 FR.05 Professional Services and Consulting Agreement (PSCA): Exhibit A - Scope of Work (Services, Milestones, and Deliverables)	3210 FR.05 PSCA Exhibit A - Scope of Work	October 23, 2017
3210 FR.09 Yale University Music Commission Agreement	3210 FR.09 Yale University Music Commission Agreement	January 12, 2021
3215 FR.01 Yale Purchasing Card Cardholder Agreement	3215 FR.01 Yale University Purchasing Card Cardholder Agreement	May 2, 2019
3215 FR.03 Purchasing Card Application for Reactivation of Individual Card	3215 FR.03 Purchasing Card Application for Reactivation of Individual Card	July 1, 2017
3215 FR.06 Purchasing Card Request Form	3215 FR.06 Purchasing Card Request Form	September 11, 2019
3215 FR.07 Request to Delegate Authority to Prepare Expense Reports and Spend Authorizations	3215 FR.07 Request to Delegate Authority to Prepare Expense Reports and Spend Authorizations	July 13, 2017
3215 FR.09 120-366 Day Taxable Expense Reimbursement	3215 FR.09 120-366 Day Taxable Expense Reimbursement	April 6, 2018
3215 FR.10 Individual & Department PCard Exceptions	3215 FR.10 Individual and Department PCard Exceptions	July 13, 2017
3220 FR.02 Application for Controlled Substance Laboratory License - State of CT	3220 FR.02 Application for Controlled Substance Laboratory License - State of CT	June 20, 2017
3220 FR.04 COA Approval for State DCD Controlled Substance License	3220 FR.04 COA Approval for State DCD Controlled Substance License	June 20, 2017
3301 FR.04 Request for Travel Grant	3301 FR.04 Request for Travel Grant.pdf 3301 FR.04 Request for Travel Grant.xlsx	March 3, 2016
3301 FR.05 Missing Receipts Form	3301 FR.05 Missing Receipts Form	March 29, 2018
3301 FR.06 Documentation for Travel on a Non-U.S. Air Carrier	3301 FR.06 Documentation for Travel on a Non-U.S. Air Carrier	January 13, 2021
3401 FR.01 Supplier Payment Setup: Wire Transfer	3401 FR.01 Supplier Payment Setup: Wire Transfer	September 15, 2020
3401 FR.02 Supplier Payment Setup: ACH/EFT	3401 FR.02 Supplier Payment Setup: ACH/EFT	June 30, 2020
3401 FR.03 Supplier Contact Information Form	3401 FR.03 Supplier Contact Information Form	January 11, 2021
3401 FR.04 Centralized Billing Account Maintenance	3401 FR.04 Centralized Billing Account Maintenance	November 26, 2018
3401 FR.06 Invoice Cover Sheet for International Activities	3401 FR.06 Invoice Cover Sheet for International Activities	July 1, 2017
3410 FR.01 Athlete or Entertainer Request for Reduced Withholding (Form CT-588)	3410 FR.01 (Form CT-588) Athlete or Entertainer Request for Reduced Withholding	August 7, 2017
3410 FR.02 Athlete or Entertainer Request for Waiver of Withholding (Form CT-590)	3410 FR.02 (Form CT-590) Athlete or Entertainer Request for Waiver of Withholding	August 7, 2017
3415 FR.01 International Information Form (IIF) for International Short-Term Visitors & Scholars	3415 FR.01 International Information Form (IIF) Form for International Short-Term Visitors & Scholars - Form & Instructions	February 18, 2020
3415 FR.02 Exemption From Withholding on Compensation for Independent (and Certain Dependent) Personal Services of a Nonresident Alien Individual (IRS Form 8233)	3415 FR.02 (IRS Form 8233) Exemption From Withholding on Compensation for Independent (and Certain Dependent) Personal Services	August 4, 2017
3415 FR.04 Statement of Foreign Source Payments	Statement of Foreign Source Payments	January 8, 2019
3501 FR.01 Payroll Costing Allocation Form	3501 FR.01 Payroll Costing Allocation Form	June 20, 2017
3501 FR.02 CT/MP Paid Time Off Adjustment Form	3501 FR.02 CT/MP Paid Time Off Adjustment Form	October 23, 2017
3501 FR.03 Payroll Accounting Adjustment Form	3501 FR.03 Payroll Accounting Adjustment Form	June 20, 2017
3501 FR.04 Direct Deposit Request	3501 FR.04 Direct Deposit Request	October 20, 2017
3501 FR.05 Direct Deposit Pull Authorization	3501 FR.05 Direct Deposit Pull Authorization	October 20, 2017
3501 FR.06 Overpayment Recovery Form	3501 FR.06 Overpayment Recovery Form	February 13, 2020
3501 FR.07 Payroll Payment Adjustment Form	3501 FR.07 Payroll Payment Adjustment Form	September 9, 2020
3501 FR.08 Stop Payment & Re-Issue Request	3501 FR.08 Stop Payment & Re-Issue Request	December 6, 2019
3501 FR.09 Vacation or Salary Advance Request Form	3501 FR.09 Vacation or Salary Advance Request Form	January 27, 2020
3501 FR.10 Faculty Request for Moving Allowance	3501 FR.10 Faculty Request for Moving Allowance.pdf 3501 FR.10 Faculty Request for Moving Allowance.xlsx	March 2, 2016
3501 FR.11 Gift to Yale - Payroll Deduction Request	3501 FR.11 Gift to Yale - Payroll Deduction Request	November 2, 2017
3501 FR.14 Payroll Deduction Request for Personal PCard Transactions of Separating Employee	3501 FR.14 Payroll Deduction Request for Personal PCard Transactions of Separating Employee	January 10, 2019
3501 FR.17 Position Review -- Medical School only	3501 FR.17 Position Review -- Medical School only.pdf 3501 FR.17 Position Review -- Medical School only.xls	August 27, 2004
3501 FR.51 Application for Faculty Child Care Grant	3501 FR.51 Application for Faculty Child Care Grant	September 16, 2019
3501 FR.55 Application for M&P Sabbatical	3501 FR.55 Application for M&P Sabbatical.xls	April 2, 2014
3502 FR.01 Temporary Employee Payment Request	3502 FR.01 Temporary Employee Payment Request	October 25, 2017
3503 FR.01 Onboarding a New Employee Checklist	3503 FR.01 Onboarding a New Employee Checklist	April 8, 2020
3503 FR.02 Promotion & Transfer Checklist	3503 FR.02 Promotion & Transfer Checklist	March 16, 2018
3503 FR.03 Termination Checklist		April 7, 2021
3503 FR.24 Professional Student Payment Setup and Job Change Form	3503 FR.24 Professional Student Payment Setup and Job Change Form	September 19, 2017
3503 FR.25 Professional School Student Payment Form	3503 FR.25 Professional School Student Payment Form	August 17, 2017
3505 FR.01 Out-of-State (U.S.) Hiring & Placement Questionnaire	3505 FR.01 Out-of-State (U.S.) Hiring & Placement Questionnaire	February 1, 2019
3505 FR.02 Out-of-State (International) Hiring & Placement Questionnaire	3505 FR.02 Out-of-State (International) Hiring & Placement Questionnaire	June 22, 2020
3510 FR.01 Relocation Reimbursement Request	3510 FR.01 Relocation Reimbursement Request	January 2, 2020
403(b) Deferral at Termination or Retirement form	403b-deferral-at-termination-or-retirement_2016.pdf
4209 FR.04 Request for Capitalization of MEI Composite Assets and Accessories	4209 FR.04 Request for Capitalization of MEI Composite Assets and Accessories	May 18, 2017
4209 FR.05 Capital Equipment Transfer Release Form	4209 FR.05 Capital Equipment Transfer Release Form	June 1, 2017
500 FR 1 Financial and Non Financial Interests in Human Research Disclosure: Yale IRB Members and Staff	500 FR.1 Financial and Non Financial Interests in Human Research Disclosure: Yale IRB Members and Staff	August 24, 2012
Adoption Reimbursement Claim Form	Adoption Reimbursement Claim Form
Aetna Medical Claim Form	Aetna Medical Claim - form
Aetna Prescription Home Delivery Order Form	Aetna Prescription Home Delivery Order Form
ALICE Request Form	ALICE Request Form	July 8, 2013
Application For Permission To Have Custom Antibodies Manufactured	Application For Permission To Have Custom Antibodies Manufactured	December 1, 2010
Authorization for Relocation Allowance
Benefits Revision Request form	benefits_revision-request.pdf
C&T Performance Feedback Resources	C&T Performance Feedback form Instructions for completing the C&T Performance Feedback form Sample C&T Performance Feedback form SMART Goal Setting Guide Video: Performance Feedback for Clerical and Technical Employees
Carryover Report FY16 - Supervisor version	carryoverreport-supervisor.xls
Child Assent Form	Child Assent Form	February 15, 2017
Child Scholarship Plan for the Faculty and Staff of Yale University (Online Application)	Child Scholarship Application
Clerical and Technical Job Audit Forms	Job Audit Timeline Job Audit Form for Grade B, C & D Upgrades Job Audit Form for a Grade E Upgrade
College Savings 529 - forms	College Savings 529 (CHET) Payroll Direct Deposit College Savings 529 (CHET) Application	January 29, 2021
Conflict of Interest Travel Form	Conflict of Interest Travel Form
CT Administrative Regulations	CT Administrative Regulations
CT Paid Sick Leave Act	CT Paid Sick Leave Act
CT Paid Sick Leave Act (Spanish)	CT Paid Sick Leave Act (Spanish)
Delta Dental Claim Form	Delta Dental Claim Form
Dental	Delta Dental Care Plan (Non-Union) Delta Dental Care Plan (Union) 2015 CIGNA Dental Care Plan
Discrimination is Illegal	Discrimination is Illegal
Draft Summary Revision Template	Draft Summary Revision Template	September 7, 2005
Electronic Monitoring	Electronic Monitoring
Employee Polygraph Protection Act	Employee Polygraph Protection Act
Employee Rights under the NLRA	Employee Rights under the NLRA
Equal Employment Opportunity	Equal Employment Opportunity
External Revenue Form	External Revenue Form
EyeMed Vision Claim Form	EyeMed Vision Claim Form
Facilities Work Request	Facilities Work Request Link	December 18, 2013
Family Medical Leave Act (FMLA)	Family Medical Leave Act (FMLA)
Federal Minimum Wage Law	Federal Minimum Wage Law
Flexible Spending Account (FSA) - forms	Statement of Medical Necessity (SOMN) - FSA Tuition Assistance (Employee) - FSA Health Care Claim Form-FSA Dependent/Child Care Reimbursement Claim Form
Flexible Spending Accounts (FSA) - Reimbursement Plan	Healthcare/Dental Reimbursement Plan Dependent Care Reimbursement Plan
Flexible Work Arrangement (FWA) Manager Log	fwa_manager_log.xlsx
FLSA Forms and Documents	FLSA Questionnaire
FMLA Revised Regulations	FMLA Revised Regulations
Form I-20 Sample	I-20 Sample
Form SSA-7028 - Sample (Notice to third party of SSN assignments)	Form SSA-7028 Sample.pdf
Form T-200	Form-T-200.pdf
Form T-400, CERTIFICATE OF LOCATION OF PROFESSIONAL SERVICES	Form T-400 CERTIFICATE OF LOCATION OF PROFESSIONAL SERVICES	October 1, 2016
Form Template	Form Template	September 5, 2007
Genetic Information Nondiscrimination Act of 2008	Genetic Information Nondiscrimination Act of 2008
Group Accident Insurance	Colonial Group Accident Certificate
Guide Template	Guide Template	October 17, 2006
Human Participants	Human Research Forms & Templates	September 12, 2013
IRS Form 8300	f8300.pdf Form 8300 Sample
Lead Administrator Feedback on Change Partner Network	Lead Administrator Feedback on Change Partner Network
Life Insurance - Forms	GROUP LIFE INSURANCE POLICY GROUP POLICY AMENDMENT NO. 1 GROUP POLICY AMENDMENT NO. 2 GROUP POLICY AMENDMENT NO. 3 GROUP POLICY AMENDMENT NO. 16 NOTICE OF PLAN CHANGE Schedule of Insurance Group Policy Amendment NO. 4 CERTIFICATE AND SUMMARY PLAN DESCRIPTION GROUP LIFE INSURANCE
Life Insurance - forms	Absolute Assignment FORM
Local 35 Training Form	local-35-training-form.doc
Long-Term Care	Monumental Plan
Long-Term Disability (LTD) Telephone Filing Instructions	Long Term Disability (STD) Telephone Filing Instructions	April 10, 2019
Long-Term Disability - Standard - Forms	Post Doctoral Associates and Faculty Members no YURAP Faculty, M&P Certificate Medical School Faculty Certificate Non-exempt Members Not Represented by YPBA Certificate M&P who does not participate in YURAP and Police Officers represented by YPBA Certificate Group Policy Amendment NO 17
M&P Job Evaluation Questionnaire	M&P Job Evaluation Questionnaire
M&P Performance Feedback Resources
Managed Care	Managed Care
Manager Checklist for New Employees
Medical - Aetna Plan Members (C&T and S&M) - forms	Benefit Plan – Aetna Select Schedule of Benefits – Aetna Select Aetna Select – (Non-CT Residence) Summary of Benefits & Coverage – AETNA Select AETNA Select (Non-CT Residence) Benefit Plan – Legacy Aetna Choice (Base Rx) Legacy AETNA Choice (Alt. Rx) Schedule of Benefits – Legacy AETNA Choice (Base Rx) Legacy AETNA Choice (Alt. Rx) Summary of Benefits & Coverage – Legacy AETNA Choice (Base Rx) Legacy AETNA Choice (Alt. Rx)
Medical - Aetna Plan Members (Faculty and M&P)	Benefit Plan - AETNA Smart Care W/ Optional Health Saving Account Schedule of Benefits - AETNA Smart Care W/ Optional Health Saving Account Summary of Benefits & Coverage (SBC) - AETNA Smart Care W/ Optional Health Savings Account Benefit Plan - AETNA Choice Schedule of Benefits - AETNA Choice Summary of Benefits & Coverage (SBC) - AETNA Choice Benefit Plan - Legacy Aetna Choice Schedule of Benefits - Legacy Aetna Choice Summary of Benefits & Coverage (SBC) - Legacy AETNA Choice
Medical - Aetna Plan Members (Security)	Benefit Plan - Aetna Select Schedule of Benefits - Aetna Select Schedule of Benefits - Aetna Select - (Non CT Residence) Summary of Benefits & Coverage (SBC) - AETNA Select Summary of Benefits & Coverage (SBC) (Non CT Residence) - AETNA Select Benefit Plan - Legacy Aetna Choice (Base Rx) Schedule of Benefits - Legacy Aetna Choice (Base Rx) Summary of Benefits & Coverage (SBC) - Legacy AETNA Choice
Medical - Aetna Plan Members (Yale Police Benevolent Association)	Benefit Plan - AETNA Smart Care W/Optional Health Savings Account Schedule of Benefits – AETNA Smart Care W/Optional Health Savings Account Summary of Benefits & Coverage – AETNA Smart Care W/Optional Health Savings Account Benefit Plan – AETNA Choice Schedule of Benefits – AETNA Choice Summary of Benefits & Coverage – AETNA Choice Benefit Plan – Legacy AETNA Choice (Base Rx) Legacy AETNA Choice (Alt. Rx) Schedule of Benefits – Legacy AETNA Choice (Base Rx) Legacy AETNA Choice (Alt. Rx) Summary of Benefits & Coverage – Legacy AETNA Choice (Base Rx) Legacy AETNA Choice (Alt. Rx)
Medical - YHP Members - forms
Military FMLA Leave Amendment	Military FMLA Leave Amendment
Model COI (Conflict of Interest) Disclosure Form	Model COI (Conflict of Interest) Disclosure Form	January 28, 2013
Model COI Form	ModelCOIform.docx
New P. O. Box Request
Notice of Policy Applicable to Individual w/ Disability, Protected Veterans	Notice of Policy Applicable to Individual w/ Disability, Protected Veterans
OSHA	OSHA
Parking and Transit Forms	Parking	August 15, 2013
Policy Template	Policy Template	August 17, 2006
Post-Award Partnership Agreement	Post-Award Partnership Agreement	March 1, 2016
Pregnancy Discrimination and Accommodation in the Workplace	ss46a_pregnancy_disability_poster.pdf
Pregnancy Discrimination and Accommodation in the Workplace - Spanish	ss46a_pregnancy_disability_poster_spanish.pdf
Procedure Template	Procedure Template	August 17, 2006
Request for Service (RIS)	Yale Printing & Publishing Services Link	February 28, 2002
Research Performance Progress Report (RPPR) Checklist	Research Performance Progress Report (RPPR) Checklist
Sexual Harassment	Sexual Harassment
Short-Term Disability (STD) Telephone Filing Instructions	Short Term Disability (STD) Telephone Filing Instructions
Short-Term Disability - Forms	SHORT-TERM DISABILITY INCOME BENEFIT PLAN
Special Permission to Serve as PI	Special Permission to Serve as PI	February 15, 2017
Standard Life Insurance - Death Claim Form	Standard Life Insurance - Death Claim Form
Subaward Reconciliation Form	Subaward Reconciliation Form
Summary Annual Reports & Required Disclosures - Forms	2014 Summary Annual Reports 2020 Notice of Creditable Coverage for Active Participants 2020 Notice of Creditable Coverage for Retired Participants Affordable Care Act Notice - Non-covered employees Affordable Care Act Notice - Covered employees Early Retiree Reinsurance Notice Medicaid and the Children’s Health Insurance Program (CHIP) Women’s Health Rights Under the Newborns’ and Mothers’ Health Protection Act of 1996 (NMHPA) Women’s Health and Cancer Rights Act (WHCRA) 2019-2020 Annual Funding Notice for Yale University Retirement Plan for Staff Employees Matching Retirement Plan Summary Annual Report Tax-Deferred 403(b) Savings Plan - Summary Annual Report YURAP Summary Annual Report Yale Retirement Savings Program plan and Investment Notice Tax-Deferred 403(b) Savings Plan Annual Notice YURAP Annual Notice Matching Retirement Plan Annual Notice 2017 Notice of Privacy Practices 2018-2019 Form 5500 for Yale University Retirement Plan for Staff Employees
Summary of Benefits and Coverage (SBC) Information Notices - forms	Yale Health, Salaried Yale Health, Clerical & Technical, Service & Maintenance, Security Yale Health, Yale Police Benevolent Association	January 11, 2021
TR&S Request For Service
Training Grant Encumbrance Form	Training Grant Encumbrance Form
Tuition Reduction Application	Tuition Reduction Application
USERRA	The Uniformed Service Employment and Reemployment Rights Act (USERRA)
Vehicle Disposal Form	Vehicle Disposal Web Form	September 21, 2013
Vehicle Disposal Form
Workers’ Compensation - forms	Workers’ Compensation Health Service Appointment
Workers’ Compensation Act - Notice to Employees	Workers’ Compensation Act - Notice to Employees
Yale Budgeting Tool (YBT) Access Request Form	Yale Budgeting Tool (YBT) Access Request Form	October 11, 2017
Yale University Scholar Awards Program - FACE PAGE	face-page-2019.pdf	January 23, 2019
YHP Claim Form	Yale Health Claims
YSS Out of Pocket form	YSS Out of Pocket form