HomeMy WebLinkAboutPersonnel Action Request - Public Works (003)F"ERSONNEL ACTION REQUEST (PAR)
Section:( Cori Employee Data (Cent Data Required
EM a 3765 Legal Name: LUTZ, BRITTANY .EILEEN ffective Date:
5�21
Section _ E!!jployee Data�Re. UIre
, for New Hkes, Separations, or if Changing)
Item Curren; Date "
ew Data
Name Legal
CI,Preferred Bri*ttany Eileen Lutz Enter ""s+.��
Address
Telephony _-J - ext,
SS - BirthdateL)6/88 000.00-0000
sto
Action(s) LeaveData
Other (Provide Comments) Type Reason
Start Date oo/oo/ooA
Sto Date
00/00/00 Eli *bIefor Rehire
.provide Details gfLe2aration Beloto
tents
Stipend - Per Pay Period
Sectio
. Iterns (Current Data- Required)
Item
CurrentData ------ _,_ New Data -
dept# -Dept-- ----- blit -Works-10105
JOb# Job Title------ � -- . -Secretary/ . c on t 000 -00 -<.Enter Title>
Hire — Psn //3 - 12/19/1
00/00100- 00100/00
G -#-Nam A04 -Public Works A
:employee Type Full Time Regular
Section -- Seeondavy items Rie.. nl ff Changing)
ItemCut-rent Data New Data
Base Wage $00.0o
<Select Cycle>$00.00 <Select
.Band/ Step
Stipend $16o.0000 Ot
$00.0000--- S Type>Pay Type/:LSA AA
ffE A A
F EGr S only <En >
....... ..< Er>
.thong Signatures
Human Resources: /09121
Date:
Board Approve Re U -1 -red,, N, 0
Chair:
Date,
2,D
Member,
Revised 0 7/1 Oil 19