Scholarship Program PDF
04/07/2019 - 0.13MB
Revised 4-7-19

Scholarship Program Fill Save
04/07/2019 - 0.03MB
Revised 4-7-19

Life Insurance Policy
04/27/2018 - 0.11MB

Change of Beneficiary Form Fill Save
04/16/2018 - 0.11MB
This form must be completed and signed to change the beneficiary to the life insurance policy

Change of Beneficiary Form PDF
04/16/2018 - 0.12MB
This form must be completed and signed to change the beneficiary to the life insurance policy

NJLECOA Membership Application Fill-Save
11/20/2017 - 0.11MB

NJLECOA Membership Application Static
11/19/2017 - 0.36MB

Major Disciplinary Appeal Form
05/15/2011 - 0.21MB
NOTE: Your appeal will NOT be processed unless Sections 1-4 are completed and the three documents listed in Section 5 are included. Pursuant to P.L. 2010, c. 26, effective July 1, 2010 there is a $20 fee for disciplinary appeals. Please include the required $20 fee with your appeal. Payment must be made by check or money order only, payable to NJ CSC and sent to the CSC, Unit H, P.O. Box 312, Trenton, N.J. 08625. Persons receiving public assistance pursuant to P.L. 1947, c.156 (C.44:8-107 et seq.), P.L.1973, c. 256 (C.44:7-85 et seq.), or P.L.1997, c.38 (C.44:10-55 et seq.), and veterans as defined by N.J.S.A.11A:5-1 et seq. are exempt from this appeals fee. If you have been suspended or removed, you should seek alternate employment. In case your penalty is reduced, failure to seek alternate employment could reduce your back pay award.

Appeal of Minor Disciplinary Action
11/11/2010 - 0.21MB
Form used to appeal any notice of suspension or fine of five days or less or an official written reprimand.

Grievance Procedure Form
10/16/2010 - 0.02MB

Application to Change or Cancel Retirement
08/20/2010 - 0.02MB
Application to Change or Cancel Retirement.

Application for Lump Sum Earned & Unused Sick Leave for Retirees
08/20/2010 - 0.25MB
Application for Lump Sum Supplemental Compensation for Earned and Unused Sick Leave for Retirees.

PERS Disability Retirement Application Fill-In Form
08/20/2010 - 0.24MB
Forms used to file for a disability retirement in PERS.

PERS Retirement Application Fill-In Form
08/20/2010 - 0.11MB
Form used to file for retirement in PERS.

Request for PERS Retirement Estimate Fill-In Form
08/20/2010 - 0.05MB
Form used to request a retirement estimate in the PERS system.

PFRS Disability Retirement Application
08/20/2010 - 0.18MB
Form used to file for a disability retirement.

PFRS Retirement Application
08/20/2010 - 0.18MB
Form used to file for retirement.

Request for PFRS Retirement Estimate Fill-In Form
08/20/2010 - 0.03MB
This form is used to request a retirement estimate.

Position Classification Questionnaire
08/20/2010 - 0.11MB
This form is used to obtain information about a position. It will be used to determine the classification or to determine a rate of pay.

Veterans Preference Claim Fill-In Form
08/20/2010 - 0.06MB
Form used to claim Veterans Preference for NJ Civil Service Exams.

Medical Authorization for Make-Up Promotional Exam
08/20/2010 - 0.03MB
For Make-up Examinations Involving Professional Engineering Promotional Announcements and All Public Safety Announcements.

Certification-of-Healthcare-Provider Form (FMLA)
08/20/2010 - 0.04MB
Form to be filled out by your physician when requesting FMLA

Leave-of-Absence Request Form (FMLA, FLA, etc.)
08/20/2010 - 0.03MB
REQUEST FOR LEAVE WITH OR WITHOUT PAY

Methicillin Resistant Staphylococcus Aureus (MRSA) Questionnaire
08/20/2010 - 0.02MB
This questionnaire is to be completed by each employee who claims exposure to Methicillin Resistant Staphylococcus Aureus (MRSA) while on duty.

Affidavit of Mitigation for Back Pay Form
08/20/2010 - 0.03MB
Form used to receive back pay once you have been returned to pay status.

Law Enforcement Officer & Firefighter Removal Appeal Form
08/20/2010 - 0.25MB
Use this form to submit an appeal of removal of a law enforcement officer or firefighter to the Office of Administrative Law and Civil Service Commission