HomeMy WebLinkAboutPersonnel Action Request - BOCCPERSONNEL ACTION REQUEST PARg)
Section -L - Core, Employee Data (Current Datta Required)
I CX
Empl#- 5286 Legal Name,,- JERRY GINGRICH I EffectiVe Date: 0.
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Section:! - Em VFW-
ployee.Data (Required for New Hires, Separations, or if Changing,
Item. Currexit Da.ta New Data
Ot Unp I
Naine
Preferred <Enter'>
Address <Enter>
Telephone (000) 000-0000 ext*
extil
SSS ,-BI#rthdate 000-00-0004)— 00/010/00 000-00-0000 — 00/00/oO
S60n 3 Requested Action
Action(s) Leave Data Separation Data
Wa
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oo- -- - ------------------
ge Change - Rec1twiffimation A TSP e Reason
Start Date Oo/oo/00 A A
A
Stop Date 00/oo/oo .rel igiblefor, hlre
I
Provide Deta7s of Se. 6 n Below
Seri On 4 - C01" en
Reclassfiring position from Band 7 to Band lo.
Deptity, Clerk of the Board 1 -Mll be at Band 8 -
Deputy Clerk of the Board 2 will be at Band
Core Items (Current..Data
Required)
Item
Cument-Data
New Data
Dept - Dept.
Commissioners'Office- oonol
A A
Job# -Job Title-eput-
101D
13 yr Clerk
0 00 -00 -Deputy Clerk of the Board 2
Hire — PositlOn
05/04/17 02/16/18
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05/04/17 o8/16/i
Grp# -Name
N05 -Non -Exempt
A
Emplovee 1% ype
1kill Time Recrular
A
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Seeflon 6 - Secondary items (Required
onty if Changin,"
lte.m
Current Do to
New Data
Base Wage
$24-08 Ho� Url
--- -----
$25.4o <Select Cvcle>
Band / Step
07/05 110/02
- -- ------ -------
Stipend,
81 0O.-OPOO <Select T ----- -
$00.0000 <Select Typ'e>
Pay, Tyrpe/FLSA
Non -Exempt — Salaried (SALYNE)
A
FTE
1.0 ( 4o hair s/-��rk)
-----------
A
FTE—GrIS Only
<Enter>
<Enter>
"oW
orkw-eek
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Standard Sun -$at
A
Section 7 - Authorizing SiLrn'atures
Department.- Date-,
Main Re�sofulrces:
Date-:
Board Approval Re ed",., iNot Re 11
Chair*.
Vice -Chair:
Date.
Members.
N
wa
UW yam.
Revised 05/25"10-