HomeMy WebLinkAboutPersonnel Action Request - JuvenileJ PERSONNEL ACTION REQUEST (PAR)
Section t - Core Employee Data (Current Data Required)
Empl#: 5045
Legal Name: Palacios, Suahil I5 U14,4 1 L
Effective Date: 12/01/19
Section 2 - Employee Data (Required for New Hires, Separations, or if Changing)
Item
Current Data
New Data
Name °Legal
❑ Preferred
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS# - Birthdate
000-oo-0000 — 00/00/00
000-00-0000 — 00/00/00
Section 3 - Requested Action
Action(s)
Leave Data
Separation Data
Position Change - Promotion
^
^
Start Date 00/00/00
Stop Date 00/00/00
Type
^
Reason
^
Eligible for Rehire ^
Provide Details of Separation Below
Section 4 - Comments
Section 5 - Core Items (Current Data Required)
Item
Current Data
New Data
Dept# -Dept
^ Youth Services -001117
Youth Services -001117
Job# -Job Title
117 -13 -Intensive Sprvision Counselor
117 -01 -Juvenile Court Administrator
Hire — Position
06/08/09 - 03/26/18
06/08/09 - 12/01/19
Grp# -Name
A03 -Youth Services
Noe -Department Head
Employee Type
Full Time Regular
Full Time Regular
Section 6 - Secondary Items (Required only if Changing)
Item
Current Data
New Data
Base Wage
$29.41 Hourly
$7,524.00 Monthly
Band / Step
12/o6
20/1
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay Type/FLSA
Non -Exempt — Salaried (SALYNE)
Exempt (SALRYE)
FTE
1.0 (4o hrs/-vvk)
1.0 (4o hrs/wk)
FTE—GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
Standard Sun -Sat
Section 7 -Authorizing Signatures
Department: /." Date:
Human Resources: _! Date:(
Board Approval{ Required ❑ Not Required
Chair:
Vice -Chair: �..� e. � �,-�., Date:
t t2
Member:
Revised 09/23/19