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Human Resources | Frequently Asked Questions | Forms


Completed forms should be turned into LLE's Personnel Manager unless otherwise noted. Questions should be directed to LLE's Personnel Manager; contact information is listed below.

Personal Data Form (.doc)

UR Dental Claim Form (.pdf)

Aetna Claim Form (.pdf)

Excellus BCBS Form (.pdf)

NYS IT-2104 Employee's Withholding Allowance Certificate (.pdf)

Additional NYS Tax Forms

IRS W-4 Employee's Withholding Allowance Certificate (.pdf)

Additional IRS Forms

Work Order Form (.pdf)

FSA Claim Forms and Information

Tuition Benefits


Send your LLE-related Human Resources questions/concerns via one of the methods listed below:

E-mail
Personnel Services Manager

Phone
(585)275-4459

Mail
Personnel Services Manager
University of Rochester
Laboratory for Laser Energetics
250 E. River Road
Rochester, NY 14623-1299