HomeMy WebLinkAboutPersonnel Action Request - Human ResourcesPERSONNEL ACTION REQUEST (PAR.)
Section — Core Employee Data (An sections required to be filled out)
Empl#: 5885 1
Legal Name: Anderson -Cook, James Donald
1 Effective Date: 03/15/26
Section 2 — Employee Data (Only required for new/separated employees & address changes)
Item
Current Data
NewlChanging Data
Name 1 0 6-1 Leaa .0 Preferred
Address
Telephone
(000) 000-0000 ext.
t000) 000-0000 ext.
SS# - Birthdate
—
000-00-0000 — 00/00/00
Section 3 — Requested Action
Action(s) to .0
Attendance - Leave Data
Separation Data
Wage Change - Step Increase
A
A
Start Date oo/oo/oo
Stop Date 00/00/00
Type
A
Reason
A
Eligiblefor Rehire - Dept A
Section 4 — Comments (for Separafions, list the last dayl&te of R,!!Y)
Jim's anniversary date is has step/wage 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
De-kr Sendces-Bldg Fire-138116 A
A A
job# -Job Title
111-14-Director of Development Senric
Hire — Position
05/24/21- 03/02/25
Grp# - Name
NO2-Department Head
A
Employee Type
Full Time Regular
A
Base Wage
$10,880.13 Monthly
$62-77
$11,195.6o Monthly
$64-59
Band / Step
22/2
22/3
Stipend
$oo.00 <SelectTvpe>
$oo.00 <Select T�q)e>
Pay Type/ FLSA
Exempt (SALRYE)
A
FTE
1.0 (4o hrs/-%,N,,rk)
A
WorkvNreek
Standard Sun -Sat
A
Section 7 — Author!nng SMTatures
Department: 4v, Date: va fe
Human Resources: Date:
Eligible for Rehire - County A
Board Approval Q Required 0 Not Required
Chair: �i -.�- � ' -��
Vice - Chair: Date:
Member:
V
HR use only
1:1 NG TT E']'❑- PAR 0 CMT t7 LXP F-1 1-9 F-1 ACCTG El DEPT F-1 TT❑NaA El TS FINT F-1 DRS DHEQ
Revised 10/08/25