HomeMy WebLinkAboutPersonnel Action Request - BOCC (003)PERSONNEL ACTION REQUEST (PAR)
Section 1— Core Employee Data (Current Data Required)
Empl#: 4339
Legal Name: RICHARD STEVENS
I Effective Date: 12/31/20
Section 2 — Employee Data (Required for New Hires, Separations, or if Changing)
Item
Current Data
New Data
Name ❑ pre erred
RICHARD STEVENS
<Enter>
Address
<Enter>
Telephone
(509) -0000 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
Separation (Provide Data)
^
^
Start Date 00/00/00
Stop Date 00/00/00
Type
Retirement
Reason
Personal
Eligible for Rehire Yes
Provide Details of Separation Below
Section 4 — Comments
Section 5 — Core Items (Current Data Required)
Item
Current Data
New Data
Dept# -Dept
Commissioners' Office-oo11o1
^ ^
Job# -Job Title
101 -01 -County Commissioner District 1
000 -00 -<Enter Title>
Hire — Position
01/01/05 - 01/01/05
00/00/00 - 00/00/00
Grp# -Name
Not -Elected Official
^
Employee Type
Full Time Regular
^
Section 6 — Secondary Items (Required only if Changing)
Item
Current Data
New Data
Base Wage
$oo.00 <Select Cycle>
$oo.00 <Select Cycle>
Band / Step
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay Type/FLSA
^
^
FTE
^
^
FTE—GrIS Only
<Enter>
<Enter>
Workweek
^
^
Section 7 — Authorizing Signatures
Department: Date:
Human Resources: Date: 12/01/20
Board Approval I] Re u red Not Yquired
Chair: 4
Vice -Chair: ��„� Date: 2-
Member: V E D
DEC - 2 202.
Revised 08/24/2020
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