HomeMy WebLinkAboutPersonnel Action Request - RenewPERSONNEL ACTION REQUEST (PAR
OA:IL' _ .. ..1 _Cv-_ r e Em to .ee Data Curren D a., e Wred
Empl#: 0025
Legal Name: Anderson, Dell
Effective Date: 11/20/22
Ob _ •
:Section=2.
- m to ee Data, : Re uired:for.:
New_Ihres= Se aratio
:._P Y __.._ ,. .. - _ ns, or if. Charg�n
Item
Current Data
New Data
Name ❑ Legal
❑ Preferred
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS* - Birthdate
000-oo-0000 — oo/oo/oo
000-00-0000 — 00/00/00
Sectln .; . Re nested Acta
. q _ . •:..... ori
Action(s)
Leave Data
Separation Data
Wage Change - Reclassification
^
^
Start Date oo/oo/oo
Stop Date 00/00/00
Type
^
Reason
^
.Eligible for Rehire ^
Provide Details o Se aration Below
._ ection -min is jp_
y ,
-5" 6344 ,.. _ 9 . .-
;..........4:.,.... :..
..1,a .G.00.
,._. �...�3;35•$7
14 80* % 3.40%
_ Section._.
Gore Items it .
t-, .rent Data
Requzreci�
Item
Current Data
New Data
Dept# -Dept
Renew -Behavioral Health -1o8000
^ ^
Job#-Job Title
150 -01 -Executive Director
000 -00 -<Enter Title>
Hire - Position
07/01/19- 11/20/20
00/00/00 - 00/00/00
Grp# -Name
NO2-Department Head
^
Employee Type
Full Time Regular
^
Se :., ea ..Items a�.e it
.. . ction con
_ _ qu ed oily of _Cl�aang�ng�
Item
Current Data
New .Data
Base Wage
$11,630.67 Monthly
$12,362.13 <Select Cycle> _
Band / Step
25/7
26/4
Stipend
$oo.0000 <SelectType>
$oo.000o <SelectType>
Pay Type/ FLSA
Exempt (SALRYE)
^
FTE
1.0 (4o hrs/wk)
^
FTE—GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
^
_ ->Sectio
_ n .. Authorizan
7
Department: Date:
Human Resources: Date:
Board Approval ❑ Required F -I Not Required
Chair:
Vice -Chair: t Date: ,-
Member:
Revised 06/22/2022