HomeMy WebLinkAboutPersonnel Action Request - Human Resources (003)PERSONNEL ACTION REQUEST (PAR)
Section i -- Gore Employee Data (All sections required to be Milled out)
Empl# : 5794
Legal Name: Schmidt, Kevin R.
Effective Date:10/ / 25
Section 2 -- Employee Data (Only required for new/separated
employees & address changes)
Item
Current Data
NewlChanging .Data
Naive � Legal
'referred
Address
Telephone
(000) 000-0000 ext.
(000) 000-0000 ext.
SS# - $irthdate
—
000-00-0000 - 00/00/00
Section 3 -- Requested. Action
Action(s) (up to 2)
Attendance - Leave Data
Separation .Data
Wage Change - Step Increase
A
A
Start Date 00/00/00
Stop Date o0 o0 oo
Type
A
Reason
A
Eligible for Rehire - Dept A
Section 4 -- Comments (for Separations, list the last dLt date of a )
Annual Step Increase
Section 5 -- Gore Items -- Current Data
Section 6 - Core Items -- Chan 'n Data
Item
.All Current Data is Required
Only Changing .Data, is Required
Dept# -Dept
CS -Facilities Maintenance-o0112
A
Job# -Job Title
112--01-Maintenance Manager
000-00-<Enter Title>
Mire — Position
10/11/18 - l0/11/18
00/00/00 - 00/00/00
Grp# - Name
NO3-Manager-Superti�isor
A
Emplovee Type
Full Time Regular
A
Base Wage
$9,079.20 Monthly
$
$9,323.6o Monthly
Band / Step
18/ 4
18 / 5
Stipend
$oo.00 <Select T�Te>
$00.00 <Select Type>
Pay Type/FLSA
Exempt (SALRYE)
A
FTE
1.0 (4o hrs/wk)
A
Workweek
Standard Sun -Sat
A
ection 7 — Authorising Signatures
Department: Date: 1►- t�- C,
Human Resources: Date:
Eligible for Rehire - Countg A
Board Approval [Z Required ❑ Not Required
Chair: n.
N
Vice -Chair: Date:
Member:
AR use only
91 TT ice:. -PAR V ` ■ SZ-ACCTG 26EPT
9-TT 94aNi
Revised 10i08/25