State Payroll Services
See below for instructions for completing fillable and Excel version forms.
- AC 230 - Report of Check Returned for Refund or Exchange (Excel) (Fillable)
- AC 873 - Extra Service Payroll Voucher (Fillable)
- AC 934-P - Next of Kin Affidavit for Bureau of State Payroll Services (print) (fillable)
- AC 1394 - Application & Account for Partial Payment of Salary (Print only)
- AC 1476 P - Report of Check Exchange (Fillable)
- AC 1588 - Dual Employment/Extra Service Approval Form
- AC 2674 - W-2 Correction Worksheet (Fillable)
- AC 2714 - Undeliverable Payroll Check Report (Word template ) (Fillable)
- AC 2822 - Bureau of State Payroll Services Payroll Transaction Authorization Form (Fillable)
- AC 3173 - Agency Report of Taxable Value of Personal Use of an Employer-Provided Vehicle (Fillable)
- AC 3197 - Fax Request for Direct Deposit Stop/Reversal (Fillable)
- AC 3202 - Payroll Certification Form (Fillable)
- AC 3206 - Prior Year Social Security and Medicare Tax Refund Certification (CUNY) (Fillable) (PDF)
- AC 3206 - Prior Year Social Security and Medicare Tax Refund Certification NYS (Fillable) (PDF)
- AC 3300-S - Certification for Payment of Pre-Adjudicatory Settlement Agreements
- TD-346 - Application by Payee or Agency Representative for Issuance of Replacement Check (Fillable)
- Direct Deposit Form and Information
- Personal Privacy Protection Law Release Forms and Instructions
- Personal Privacy Protection Law Release Form Instructions
- Personal Privacy Protection Law Release Form - AC 3216
- Personal Privacy Protection Law Release Form - For Garnishment Deductions only.
- Position Data Request Forms
- SUNY Charitable Giving Campaign Form
To view, complete and print the fillable forms, you will need the Adobe Acrobat Reader software installed on your computer. This software does not allow you to save your completed or partially completed form to a disk or on your computer.
The form should be saved to the user's computer for completion and then submitted as instructed.