HomeMy WebLinkAboutPersonnel Action Request - Human Resources (004)PERSONNEL ACTION REQUEST (PAR)
Section 1 — Core Employee Data (All sections required to be filled out)
Empl#'. 2879
Legal Name: Lang, Tyson Ellsworth
Effective Date: 01/04/96
Section Employee Data (Only required for new separated_ employees & address chatiges)
Iteen
Curt-ent Data
N-ew/Chanying Data
Name :"g'l P�fl
Address
Telephone
(000) 000-0000 ext.
(000) 000-0000 ext.
SS# - Mithdate
—
000-00-0000 — 00/00/00
Section 3 — Requested Action
Action(s) (ZIP tO )
Attendance - Leave Data
Separation.Data
Wage Change - Step Increase
A
A
Start Date oo/oo/oo
Stop Date oo/oo/oo
Type
A
Reason
A
Eligible for Rehii-e - Dept
onitnents (for Separations, list the last dam date
Section 5 — Core Reim — Current Data
Section 6 — Uwe Items — Chatiging Data
Item
Al - I Curi-ent Data is Required
On li Changing Data is Required
Y
Dept# -Dept
Public Defense-oo1133 A
A A
Job# -Job Title
133-07-Ptiblic Defender
000-00- <Enter Title>
Hire — Position
01/01/14 - 01/01/20
00/00/00 - 00/00/00
Grp# - Name
Nob -Public Defender
A
Emplovee'fvpe
Full Time Regular
A
Base image
$12 582.27 Monthly
$7959
7
812,96o.13 Monthly
$74-77
Band / Step
07 / 1
07/2
Stipend
$oo.00 <Select Ty-pe>
$00.00 <Select Tyrpe>
Papt TN!pe/FLSA
Exempt (SALRYE)
A
F1'E
1.0 (40 hrs/wk)
A
Wog ka-veek
Standard. Sun -Sat
A
Section Authorizing Sipatures
Depai-trnent: Date"" i.
- --------- � �
Human Resources: Date:
Eligiblefor' Rehire -,County A
Board Approval Required ❑ Not Required
Chair: i
Vice -Chair: Date: CU
- ----- ----- ---- --
Member: - - ----- -----
V
It Ka ELS4 Otl]LV
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Revised 101"08ii.21-5