HomeMy WebLinkAboutPersonnel Action Request - BOCCPERSONNEL ACTION REQUEST (PAR)�� ��.�� , � .
Section — Core Employee Data (All sections required to be filled out) A
Empl#: 3840
----------
Legal Name: Brown, Vanessa L.
Effective Date: a3j-�
Section 2 — Employee Data (Only required for new/separated employees & address changes)
Item
Current Data
NewlChanging Data
'71 Preferred
Name ' '8'
Address
Telephone
(000) 000-0000 ext.
(000) 000-0000 ext.
SS# - Birthdate
—
000-00-0000 — 00/00/00
Section 3 — Requested Action
Action(s) (qp to 2)
Attendance - Leave DataSeparation
Data
Wage Change - Step Increase
A
A
Start Date oo/oo/oo
Stop Date o0/00100
Type
A
Reason
A
,eligible for Rehire - Dept A
Section 4 — Comments (for Separations, list the last day/date of pay)
Annual Step Increase.
Section 5 — Core Items — Current Data
Section 6 — Core Items — Changing Data
Item
All Current Data is Required
Only Changing Data is Required
Dept# -Dept
CS -Technology Services-501000 A
A A
Job# -Job Title
112-23-CS Administrative Assistant
000-00-<Enter Title>
Hire — Position
02/03/20 - 02/16/22
00/00/00 - 00/00/00
Grp# - Name
N05-Non-Exempt
A
Employee Type
Full Time Regular
A
Base Wage
$35.16 Hourly
I$
$36.18 Hourly
Band / Step
12/2
12/3
Stipend
$oo.00 <Select Type>
$oo.00 <Select Type>
Pay T)7pe/FLSA
Non -Exempt — Salaried (SALYNE)
A
FTE
1.0 (4o hrs/iArk)
A
Workweek
Standard Sun -Sat
A
Section 7 — Authorising Signatures
Department: CV, Date:
Human Resources: Date:
Eligiblefor Rehire - County A
Board Approval Required M Not Required
Chair: zo�
Vice -Chair: Date:
Member:
HR use oily
1:1 NG 1117 11 PAR El CHIT [I LXP 7 1-9 F1 ACCTG 7 DEPT 11 TT ONavi El TS ONT 0 DRS OHEQ
Revised 10/08/25