HomeMy WebLinkAboutPersonnel Action Request - Human Resources (003)P En" SONNEL ACTION REk")2UEST (PAR)" U
Section i — Core Employee Data (Current Data Required)
Legal Name: Harrell Martin Effect* e Date: ol/16/22
INT
---------- Section 2 — Employee Data (Required for New Hires, Separations, or if Changin,,,g)
Item
Current Data
New Data
<Enter>
<Enter>
Name 12, Preferred
John Martin
Address
Telephone
ext.
- ext.
SS# - Birthdate
000-00-0000 - 00/00/00
000-00-0000 - 00/00/00
Section 3 — Requested Action
Action(s) Leave Data Separation Data
Wage Change - Reclassification A Type Reason
Stait Date 00/00/00 A A
A
Stop Date oo/oo/00 Eligiblefor Rehire
Provide Details Ofseparation Below
Section,4 – Comments
Reband after completioll of compensation study
Section 5 — core items (current )kequired)
Item CurrentData it New Data
-5010
Job# -Job Title -o6-Syste- Ad,
03/2,9../0%'1- 09/24/k8__) 00/00/00 - 00/00/00
Employee T�Te t
Full Time Regular
A
---- — - Section 6 – Secondary Items (Required only if Changing)
Item
Current Data
New --Data
Base Wage
$ 6-;7zo-.t3-Monthly
$6-,779-.o7 Monthly
Band Step
16 110
Stipend
$00.0000 <Select T�Te>
$00.0,000 <Select Tv
Pay T�rpe/FLSA
Exempt (SALRYE)
A
A
FU
110 (4o hrs/wk)
Workweek Standard Sun -Sat A
Section 7 – Authorizing signatures
Human Resources:
Board Approval M Required"EINot Required
Datef
Revised ID06/202I