HomeMy WebLinkAboutPersonnel Action Request - Human ResourcesPERSONNEL ACTION REQUEST (PAR)
Section 1 — Core Employee Data (All sections required to lie filled out)
Empl#: 3839
1
Legal Name: Anderson -Cook, Decorah
Effective Date: 05/10/26
1
Section 2 — Employee Data (Only required for ne-wi/separated
employees & address changes)
-Item
Current Data
NewlChanging Data
Name C1 Le -al
11 Preferred
Address
Telephone
(000) 000-0000 ext.
(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
Stop Date o0/00100
Type
A
Reason
A
Eligible for Rehire - Dept A
Section 4 — Comments (for Separations, list the last day/date of pM)
SectiOu 5 — Core Items — Current Data
Section 6 — Core Items — Changing Data
Item
All Current Data 1'sRequired
Only Clanging Data is Required
Dept# -Dept
Human Resources-oo1124 A
A A
Job# -Job Title
124-01-Human Resources Director
-
Hire —Position
09/28/20 - 04/29/24
00/00/00 - 00/00/00
Grp# - Name
NO2-Department Head
A
Employee TNTe
Full Time Regular
A
Base Wage
$11,509.33 Monthly
$ 66-40
$11,819.60 Monthly
1$68.19
Band / Step
22/4
22/5
Stipend
$oo.00 <Select Type>
$oo.00 <Select Tvpe>
Pay TyTe/FLSA
Exempt (SALRYE)
A
FTE
1.0 (40 hrs/w1,)
A
Workweek
Standard Sun -Sat
A
Section 7 — Authoring Signatures
Department: Date:
Human Resources: Date:
Eligiblefor Rehire - County. A
Board Approval 0 Required ❑ Not Required
Chair:
Vice -Chair: Date:
Member:
HR use only
7 NG R TT FX1 PAR FX_1 CMT 17 LXP
El ACCTG 11 DEPT 1:1 TT []Navi ❑ TS EINT El DRS FMEQ
Updated 03-05-2026
Revised 10/08/25