HomeMy WebLinkAboutPersonnel Action Request - Fairgrounds (002)PERSONNEL ACTION REQUEST (PAR)
Section 1- Core Employee Data (Current DataRequired)
Empl#: 38o8
Legal Name: White,Ken
Effective Date;.�
Section 2 - Employee Data (Required for New Hires, separations, or if Chan
Item
Current Data
New Data
Name o 'Lep'
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS# - Birthdate
000-00-0000 — 00/00/00
000-00-0000 — 00/00/00
Section 3 - Requested Action
Action(s)
Leave Data
Separation Data
Wage Change - Step Increase
^
Start Date oo/oo/oo
Stop Date 00/00/00
Type
n
Reason
^
Eligible for Rehire n
Provide Details o Se aration Below
Section 4 - Comments -
Section s - Core Items (Current DateRequired)
Item
Current Data
New Data
Dept#-Dept
Fairgrounds- 1 16000 ^
Job#-Job Title
159-15-Groundskeeper
000-00-<Enter Title>
Hire — Position
07/01/14- 0&/"O' 9
00/00/00 - 00/00/00
Grp#-Name
N05-Non-Exempt
Employee Type
Full Time Regular
^
Section 6 - Secondary items (Required nly if
Item
Current Data
New Data
Base Wage
0 dog-G lea tam
Band / Step
05/05
05/o6
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay Type/FLSA
FTE
FTE—GrIS Only
<Enter>
<Enter>
Workweek
^
Section 7 - Authorizing attires
Department: , Date: It I � I
Human Resources: Date: )(q119
Board Approval ❑ Re uired Not Re ui ed
Chair:
Vice-Chair: ' Date:
Member: --
Revised 09/23/19