Election for State Retirees To Be Employed Pursuant to Section 212

Re-employment application for rehired state unclassified retirees with earnings limitation if employee is younger than 65 years. Hiring department requests applicant to complete the form; the department returns the completed form to Human Resources.

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Election For Retiree To Be Hired (Section 212).pdf
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Human Resources
University at Buffalo
Townsend Hall
205 Hayes Road
Buffalo, NY 14214

Need Help Completing the Form?

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UB HR Benefits

State Benefit Services

Phone: 716-645-7777

Email: ub-hr-benefits@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: 7/2017

Owner: Human Resources