Form S-211.1 "Request to Change Individual Status on Interdepartmental Promotion Eligible Lists" - New York

What Is Form S-211.1?

This is a legal form that was released by the New York State Department of Civil Service - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2015;
  • The latest edition provided by the New York State Department of Civil Service;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form S-211.1 by clicking the link below or browse more documents and templates provided by the New York State Department of Civil Service.

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Download Form S-211.1 "Request to Change Individual Status on Interdepartmental Promotion Eligible Lists" - New York

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STAFFING SERVICES DIVISION
Request to Change Individual Status on
Interdepartmental Promotion Eligible Lists
S-211.1 (4/2015 L)
Albany, NY 12239
If you have been permanently transferred appointed or reinstated to a new agency and your name is on an
interdepartmental promotion eligible list(s), use this form to request to have your name placed on your new agency’s
departmental portion of the interdepartmental promotion eligible list(s).
For this request to be approved, one or more of the following additional conditions must be met:
a)
You became permanently employed in the new agency after you filed but before the examination.
OR
b)
You became permanently employed in the new agency after the examination but before the list was
established and have now completed probation.
OR
c)
You became permanently employed in the new agency after the list was established and now have
completed probation and served 26 weeks in the new agency (including time served while on probation.)
PLEASE PRINT LEGIBLY
NAME:
SOCIAL SECURITY NUMBER:
HOME ADDRESS:
Street Address
City or Post Office
State
Zip Code
Is this a new address? Yes
No
Employed at:
Present Agency:
Previous Agency:
Date of appointment, transfer or reinstatement to the new Agency:
Date probationary period ended:
Examination Number
Examination Title
RETURN THIS FORM TO:
ATT: STAFFING SUPPORT UNIT
NEW YORK STATE DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
Personal Privacy Protection Law Notification
The information you provide on this application is being requested in accordance with Section 52(4) of the Civil Service
Law for the principal purpose of processing your request to have your name placed on a departmental portion of an
interdepartmental promotion eligible list(s). The information will be used in accordance with Section 96 (1) of the Personal
Privacy Protection Law, particularly subdivisions (b), (e) and (f). Failure to provide the information requested may prevent
this agency from processing your request. This information will be maintained by the Director, Division of Staffing
Services, NYS Department of Civil Service, Albany, NY 12239. For information concerning the Personal Privacy
Protection Law, call (518) 457-9375.
STAFFING SERVICES DIVISION
Request to Change Individual Status on
Interdepartmental Promotion Eligible Lists
S-211.1 (4/2015 L)
Albany, NY 12239
If you have been permanently transferred appointed or reinstated to a new agency and your name is on an
interdepartmental promotion eligible list(s), use this form to request to have your name placed on your new agency’s
departmental portion of the interdepartmental promotion eligible list(s).
For this request to be approved, one or more of the following additional conditions must be met:
a)
You became permanently employed in the new agency after you filed but before the examination.
OR
b)
You became permanently employed in the new agency after the examination but before the list was
established and have now completed probation.
OR
c)
You became permanently employed in the new agency after the list was established and now have
completed probation and served 26 weeks in the new agency (including time served while on probation.)
PLEASE PRINT LEGIBLY
NAME:
SOCIAL SECURITY NUMBER:
HOME ADDRESS:
Street Address
City or Post Office
State
Zip Code
Is this a new address? Yes
No
Employed at:
Present Agency:
Previous Agency:
Date of appointment, transfer or reinstatement to the new Agency:
Date probationary period ended:
Examination Number
Examination Title
RETURN THIS FORM TO:
ATT: STAFFING SUPPORT UNIT
NEW YORK STATE DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
Personal Privacy Protection Law Notification
The information you provide on this application is being requested in accordance with Section 52(4) of the Civil Service
Law for the principal purpose of processing your request to have your name placed on a departmental portion of an
interdepartmental promotion eligible list(s). The information will be used in accordance with Section 96 (1) of the Personal
Privacy Protection Law, particularly subdivisions (b), (e) and (f). Failure to provide the information requested may prevent
this agency from processing your request. This information will be maintained by the Director, Division of Staffing
Services, NYS Department of Civil Service, Albany, NY 12239. For information concerning the Personal Privacy
Protection Law, call (518) 457-9375.