HomeMy WebLinkAboutPersonnel Action Request - BOCC- - --------- - -
PERSONNEL ACTION REQUEST (PAR)
Section 1 - Core Employee Data (All sections required to be filled out)
Empl#: 3810
Legal Name: Gaines, Thomas A.
Effective Date: 09/14/2.5
Section 2 - Employee Data (Only required for new/separated
employees & address changes)
Item
Current Data
NewlChanging Data
Name 0 Ugal
0 Preferred
Address
Telephone
(000) 000-0000 ext.
(000) 000-0000 ext.
SS# - Biii-thdate
-
000-00-0000 - 00/00/00
Sec.tion 3 - Requested Action
Action(s) (u p to 2)
Attendance - Leave Data
�1,5Taration Data
Position Change - Promotion
A
A
Start Date oo/oo/oo
Stop Date oo/oo/oo
Type
A
Reason
A
Eligiblefor Rehire - Dept A
Section 4 - Comments (for Separations, list the last day1date 4
Tom has accepted Interim County Administrator.
--------------- ------ - Section 5 - Core Items - Current Data
Section 6 - Core Items - Changing Data
Item
All Current Leta is Required
Only Changing Data is Required
Dept# -Dept
CS-Facinties Maintenance-oo1112 A
Commissioners' Office-oollo A
job# -Job Title
112-04-Director - Central SerAces
101-25-County Administrator
Hire - Position
07/22/13 - 01/01/21.
07/22/13 - 09/14/25
Grp # - Name
NO2-Department Head
A
Employee Type
Full Time Regular
A
Base Wage
$12,102.13 Monthly
1$69.82
$13,o95.SS MOnth1Y
$75-55
Band / Step
22/7
26/1
Stipend
$00.00 <Select T�Te>
$oo.00 < Select T�Te >
Pay TNpe/FLSA
Exempt (SALRYE)
A
FFE
1.0 (4o hrs/lArk)
A
Workweek
Standard Sun -Sat
A
Section 7 - Au t�ori�zing Signatures
Department: Date:
Human Resources: Date:
Eligiblefor Rehire - County A
Board Approval F9 Required M Not Required
yj
Chair:
Vice -Chair: Date:
Member:
14R use only _4 N N6 R PAR gj CMT [:] 1-9
Acctg Dept TT Navi Kx TS FL NT
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CAD
Revised 07/08/25