Long Term Disability Waiver of Waiting Period

state employee applies to waive waiting period for long-term disability.

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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
120 Crofts Hall
2020欧洲杯体育直播投注 North Campus

Need Help Completing the Form?


UB HR Benefits

State Benefit Services

phone: 716-645-7777

Email: ub-hr-benefits@stpatrickshosp.com

Form Facts

Form Type: Downloadable, PDF document


Updated:2020欧洲杯体育直播投注 October 2012

Owner:2020欧洲杯体育直播投注 Human Resources