HomeMy WebLinkAboutPersonnel Action Request - BOCCPERSONNEL ACTION REQUEST (PAR)
Section i — Core Employee Data (All sections required to be filled out)
Empl#: 5785 I
Legal Name: Orozco, Kaylyn Jean
Effective Date: 12/o-1"7/25
Section 2 — Employee Data (Only required for new/se par
d employees & address changes)
Item
Current Data
NewlChanging Data
0 Legal
Name 9 Preferred
Address
Telephone
(000) 000-0000 ext.
SS# - Birthdate
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 oo/oo/oo
I Stop Date oo/oo/oo
Type
A
Reason
I n
Eligiblefor Rehire -Dept A
Section 4 — Comments (for Separations, list the last day/date of p2v)
Section 5 — Core Items — Current Data
Section 6 — Core Items — Chr—eng Data
Item
All Current Data is Required
Only Changing Data is Required
Dept# -Dept
Auditor's Office-Elections-oo,108 A
A A
Job# -job Title
108-12-Cert Elections Administrator
000-00-< Enter Title>
Hire — Position
1 02/03/20 - 11/27/22
00/00/00 - 00/00/00
Grp# - Name
Aol-Courthouse
A
Employee Type
Full Time Regular
A
Base Wage
$30.48 Hourly
Is
$31.27 Hourly
Band / Step
107/5
07/6
Stipend
$ o o. o o < Select Type >
$oo.00 <Select Type>
Pay Type/ FLSA
Non -Exempt — Salaried (SALYNE)
A
Fr
TEA
1.0 (4o hrs/wk)
A
Workweek
Standard Sun -Sat
A
Se
L CUO)i 7 :hAuthorizing Sign&ures
Department: Date:
Human Resources: Date:
Eligible for Rehire - County A
Board Approval Required [I Not Required
Chair:
Vice -Chair: 7z Date:
Member:
V
HR use only -IQ
11 NG C TT �LPAR d6CMT 11 LXP F-1 1-9 Cl ACCTG 0 DEPT 0 Tr 0 Navi 0 TS 0 NT 13 DRS 0 HEQ
Revised 10/08/25