Dual Appointment or Extra Service Approval

Request for approval to serve with another state agency for dual appointment or extra service.

Download the Form

Download the Dual Appointment or Extra Service Approval Form
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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?

ePTF Support

ePTF Support Staff

State Appointment Processing

Phone: 716-645-3783

HR Customer Service

Customer Service

Human Resources

Townsend Hall, South Campus

Phone: 716-645-7777

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: March 3013

Owner: New York State Office of State Comptroller