HomeMy WebLinkAboutPersonnel Action Request - BOCC (002)PERSONNEL ACTION REOUEST (PAR)
Empl#: 5286 Legal Name: Jerry Gingrich I Effective Date: o2/16/19
Section a = Em to ee Data (R wired for 1Ve�v Hires, Se stations; or if Ch"
P Y � P
Item Current Data New Data
Name " a' Jerry Gingrich Jerry Gingrich
9 14 LAI
Address - --- - - - - - _ _
Telephone (000) 000-0000 ext. (509)398 11io ext. vCL°
SS# - Birthdate 000-oo-0000 — oo/oo/oo 000-00-0000 — 00/00/00
lection 3`= Requested Action "
Action(s) Leave Data Separation Data
Wage Change - Step Increase A Type Reason
Start Date oo/oo/oo
Stop Date oo/oo/oo Eligiblefor Rehire
Provide Details o Se aration Below
Section 4 -Comments
f��ca�`-i"� a CI"C.�ij''Y1C L'L
r i C i
9 pIeC�Sc`
,n:5�I m/I
Department: Date:
Human Resources: Date:
Board Approval`] Required ❑ Not Required ,
Chaim �r
Vice -Chair: ' Date:
Member:
Revised 01/09/19
__
Section 5 -Core Items(Current Da#a R uired)
Item
Current Data
New Data
Dept# -Dept
Commissioners' Office-ooliol
n A
Job #-Job Title
101 -13 -Deputy Clerk
000 -00 -<Enter Title>
Hire - Position
05/04/17- 0� : ` t t
. 00/00/00 - 00/00/00
Grp# -Name
N05 -Non -Exempt
^
Employee Type
Other - Volunteer
Section'6 — SecondaryItems [(Required onlyif Changui
Item
Current DataNew
Data
Base Wage
$o -000-a-Eourly
f $oo-mmi-0 <Select Cycle>
Band / Step
07/02
07/03
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay- Type/FLSA
Non -Exempt - Salaried (SALYNE)
Nan -Exempt - Salaried (SALYNE)
FTE
1.0 (4o hrs/-vvk)
1.0 Coo hrs/,,vk)
FTE-GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
Standard Sun -Sat
Department: Date:
Human Resources: Date:
Board Approval`] Required ❑ Not Required ,
Chaim �r
Vice -Chair: ' Date:
Member:
Revised 01/09/19