Instructions for Completing CP-3 Change In Status Form

This form is used to change the status of current employees and for the reappointment of adjunct lecturers. Leaves and separations should include the letter of request for leave or resignation letter from the employee. The Status Change section need be completed only as far as applicable to the situation.

  1. Type of Change: Please select the appropriate box.

Current Status

  1. Name: Please indicate employee's legal name.
  2. SUNY ID: Please indicate employee's SUNY ID.
  3. Department: Please indicate employing department here.
  4. Line Number: Please indicate the employee's line number here.
  5. Account Number: Plattsburgh State account number(s) where position is to be charged.
  6. Percentage: Please indicate percentage to be charged to each account number, if using more than one account.
  7. Title: Please indicate employee's current budget title here.
  8. Salary: Please indicate current salary here.

Status Change

  1. Effective Date of Change: Please designate date when change is expected to occur here.
  2. Line Number: Will be completed by Budget office.
  3. FTE: If full time use 1.0. If part-time academic, please refer to chart below, otherwise will be determined by Budget office based on work obligation.
Teaching Credits Adjunct Lecturer FTE Teaching Credits Adjunct Lecturer FTE
1 .03 7 .23
2 .06 8 .26
3 .10 9 .30
4 .13 10 .33
5 .16 11 .36
6 .20 12 .40
  1. Budget Title/Grade: Must correlate with approved SUNY System Administration titles. (Reference the Job Specification Reference Guides or contact Human Resources)
  2. Campus Title: Descriptive title applicable to Plattsburgh State University of New York
  3. Compensation: Amount of compensation or extra service payment. 
  4. Change Amount: Please select the appropriate box.
  5. Amount: Amount that will be added to or subtracted from base salary or amount of chair stipend.
  6. Supervisor's Name: Please indicate the direct supervisor of the employee here.
  7. Appointment Type : Please select one box on each line. (Reference Board of Trustees policies Article XI, Titles A through G for definitions, if necessary)
  8. Appointment Effective: Please indicate the beginning and ending dates of the appointment here. If academic appointment, semester start date should be used.
  9. Work Obligation:* Please select one box and indicate active dates of service if "College Year" or "Other." Work obligation may differ from appointment dates. "College Year" appointments are appropriate when a professional employee will work more than 10 months but less than 12 months. "Other" appointments are appropriate for employees whose obligation differs from the available categories.
  10. If Part-time Academic: Please indicate course number(s) & course title, credits and salary per course here, if applicable.

Leave/Employee Separation

  1. Type of Leave: Please select appropriate leave category.
  2. Pay Status: Please select appropriate leave pay status.
  3. Duration: Please indicate the beginning and ending dates of the leave here.
  4. Employee Separation: Please select one and indicate effective date.
  5. Approvals/ Signature Route: Upon completion of signature approval section, HR will distribute copies to offices indicated on distribution list found at the bottom of the CP-3.

Download CP-3 Change In Status Form
(MS Word file size 44KB)

Contact Information

Human Resource Services

Address: 101 Broad Street, Plattsburgh, NY 12901-2681
Campus Location: Kehoe 912
Phone: (518) 564-5062
Fax: (518) 564-5060

Office Hours:

Monday - Friday 7:30 am - 4:30 pm