HomeMy WebLinkAboutPersonnel Action Request - Technology ServicesPERSONNEL ACTION REQUEST (PAR)
Section i - Core Employee Data (Current Data Required)
Empl#:
Legal Name: BRITTANY RANG
I Effective Date: 12/16/19
Section 2 - Employee Data (Required for New Hires, Separations, or if Changing)
Item
Current Data
New Data
Name ° 1`'a'
❑ Preferred
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS# - Birthdate
000-oo-0000 — 00/00/00
000-00-0000 — 00/00/00
Section 3 - Requested Action
Action(s)
Leave Data
Separation Data
Position Change - Transfer/Location
^
^
Start Date oo/00/00
Stop Date 00/00/oo
Type
^
Reason
^
Eligible for Rehire n
Provide Details o Se oration Below
Section 4 - Comments
Section y — Core Items (Current Data Required)
Item
Current Data
New Data
Dept# -Dept
Technology Services -501000
Commissioners' Office-oo1101 ^
Job# -Job Title
179 -16 -Business Process Admin I
101 -04 -Admin Services Coordinator
Hire — Position
12/10/12 - 01/01/19
12/10/12- 12/16/19
Grp# -Name
Nos -Non -Exempt
N04 -Exempt
Employee Type
Full Time Regular
Full Time Regular
Section 6 - Second!Items (Required only if Changing)
Item
Current Data
New Data
Base Wage
$25.o6 Hourly
$4,586.40 Monthly
Band / Step
10/03
10/05
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Ty pe>
Pay Type/FLSA
Non -Exempt — Hourly (HRLY)
Exempt (SALRYE)
FTE
1.0 (4o hrs/wk)
1.0 (4o hrs/wk)
FTE—GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
Standard Sun -Sat
Section - Authorizing Signatures
Department: ✓ . Date: /Z /0
y '
Human Resources: f `' Date:
Board Approval.. Required ❑ Not Required
Chair:
Vice -Chair: Date: 17-, t% .
Member:
Revised 09/23/19