HomeMy WebLinkAboutPersonnel Action Request - BOCC (002)PERSONNEL ACTION REQUEST (PAR) --------
Section i - Core E, mployee Data (Current Data Required)
Em
l Naga
4262 Legal BARBARA VA EZ Effective Date: 09/01/21
. ..... I - %? - ----- — - ------ ----- -
Section 2 - EmPloyee Data (Required for New Hi )
ItCurrent Data ires Separations, or if Changing)
em
New Data
N a m e
C-1 Preferred <Enter>
Address <Enter>
Telephone (000) 000-0000 ext. - ext.
SS# - Birthdate, 000-oo-0000 — 00/00/00 000-00-0000 — 00/00
SectliOn 3 - Eequested Action
Action(s) Leave Data Separation Data
Wage Change - Reclassification A Type Reason
A Start Date 00/00/oo A
Stop Date oo/oo/oo Eligiblefor Rehire A
------SProvide Details of Sepat ation Bel
ection 4 — Commentsow
------------
Section 5 - Core Items (Current Data Required)
Item Current Data New Data
Dept# -Dept Co n-im i*sS*loners' 0 ffi-ce- o o1_101 A A A
*4-1
Hire — Position
I0I-11-Actmin Assist Clerk of Board
09/01/04 - 09/01/04
N05-Non-Exem-pt-
101 1 11 -Clerk of the Board
09/01/04 09/01/21
N04 Exempt
Grp# -Name
Employee Type
Full Time Regular
A
Section 6 - Secondary Items (Required
only if Changing' ),
Item.
Current Data
New Data
Base Wage
$32.o6 Hourly
$6,051-07 Monthly
Band / S I tep
12/07
14
Stipend
$00.0000 <Select.Type>
$00.0000 <Select Tvpe>
Pay Type/ FLSA
Non -Exempt — Salaried (SALYNE)
Exem.-ot (SALRYE)
FTE
1 n rA 0 'h -r(z AAA-)
A
FTE—GrIS Only <Enter> <Enter>
Workweek Standard Sun -$at A
Department:
Human Resources:
Board Approval �]Req. ' ed
Chair*.
71�
Vice -Chain
Member
SecdOn 7 - Autho
of Renured
A
Date,
Date:
P77 41�y
Datel
Revised 05/25/2021