HomeMy WebLinkAboutPersonnel Action Request - Human ResourcesPERSONNEL ACTION REQUEST (PAID)
--- Section 1 — Core Employee Data (All sections required to he filled out)
P4
Empl#: 6221 JLegal Name: Manell,Steven Christopher Effective Date: 11/23/25
bection
Item
2 — hmp ioyee Data �Unly required for new separate
Current Data
emplo & ddrchangel)
yees aess
NewlChanging Data
Name al
11 Preferred
Address
Telephone
(000) 000-0000 ext.
(000) 000-0000 ext.
SS# - Birthdate
—
000 00-0000 — 00/00/00�wo
Section — Reauested Action
Actions ) (uP tO 2) Attendance - Leave Data Sevaration Data
Wage Change - Step Increase A Type Reason
A Start Date oo/oo/oo A I A
t Stop Date oo/oo/oo Eligible for Rehire - Dept A
Section Comments (for Sep ions
4— list- the -last day/date of pay.)
Item
Section 5 — Core Items — Current Data
All Current Data is Required
Section 6 — Core Items — Chan ",n data
Only Changing Data is Required
Dept# -Dept
Fairgounds-116000 A
A A
Job# -Job Title
159-33-Maintenance 3
000-00-<Enter Title>
Hire — Position
04/29/24 - 05/11/25
- --------- -_
00/00/00 - 00/00/00
Grp# - Name
Employee Type
N05-Non-Exempt
Full Time Regular
A
Base Wage
Band / Step
$30.07 Hourly
10/2
$30.97 Hourly
110/3
Stipend
: :ay Type/FLSA
$oo.00 <Select Type>
Non -Exempt — Hourly (HRLY'
$oo.00 <Select Type>
A
FTr",
1.0 (4o hrs/wk)
A
Workweek A
Standard Sun -Sat
A
7 — Authorlzipg Signatures
Department: Oe-
Human Resources:
Eligible for Rehire - bunty A
Board Approval 2!LRequired ❑Not Required
Chair:
Vice -Chair:
Member:
Date:
Date:
Date: 5.�q-ZfO
HR use unly
El NG OTT IC -PAR V.CMT 0 UP C1 1-9 0 ACCTG El DEPT El TT E]Navi 0 TS ONT C3 DRS OHEQ
Revised 10/08/25
11-- - a--