HomeMy WebLinkAboutPersonnel Action Request - Human Resources (004)d-m F -K, -q _V_1h I
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Section i — Core Employee Data (Current Data Required)
.Empl#, 5822 Legal Name: Jeremy Hall --------- ---------- ----
Effective Date: 006/22
Section 2. — Employee Data (Required for New Hires, Separations, or if Changing)
Item
Current Data
New Data
Name Legal
0 Preferred
Jeremy Hall
<Enter>
<Enter>
Address
Telephone
ext.
ext.
SS# - Birthdate
000-oo-0000 — 00/00/00
000-00-0000 — 00/00/00
sewl0n 3 — Requested Action
Action(s) Leave Data Separation Data
Wage Change - Reclassification A, Type Reason
Start Date oo/oo/oo A
A
Stop Date oo/oo/00 Eligible for Rehire A
.x
Provide Details of Separation Below
------- - ----- - ----- Section 4 — Comments
Reband after completion of compensation study
Section 5 — Core Items (Current Data Required)
Item
Current Data
New Data
Dept# -Dept Technolop- Services -501000 A A
Job# -Job Title 179 -07 -Technology Services Technician 000 0 0 - < Enter Title >
Hire — Position 02/05/19 - 00/-Oft/00� (3`11 C�e
Grp# -Name Nos -Non -Exempt
Employee T�Te Time Regular A
--Full
Section 6 — Secondary items (Required only if Changing)
C7.,
.Item Current Data New Data
Base Wage
$-2 �.Hourly
$29..6o Hourly
Band SteD
- -----
8/4
..........
13/1
Stipend
$00.0000 <Select Type>
$00.0000 <Select Type>
Pay Type/FLSA Non -Exempt — Salaried (SALYNE) A
FTEj 1.0 (4o hrs/-vvk) A
FTE—GrIS Only <Enter> <Enter>
Workweek Standard Sun -Sat A
Section 7 — Authoriz!Eg Signatures
Department: Date:
Human Resources Date,
Board Approval Required El Not Required
chair-,
!;A 5
Vice -Chair:
7� -7 Date:
Member:
--------------- -
Revised 10/06112021