HomeMy WebLinkAboutPersonnel Action Request - BOCC (003)PERSONNEL ACTION REQUEST (PAR)
Section 1— Core Employee Data (Current Data Required)
Empl#: 5286
Legal Name: Jerry Gingrich
Effective Date: lo/29/23
Section 2 — Employee Data (Required for New hires, Separations, or if Changing)
Item
Current Data
New Data
Name ❑ Legal
❑ Preferred
<Enter>
Address
<Enter>
Telephone
(000) 000-0000 ext.
( ) - ext.
SS# - Birthdate 1
000-00-0000 — 00/00/00
000-00-0000 — 00/00/00
Section 3 — Requested Action
Action(s)
Leave Data
Separation Data
Wage Change - Adjustment
A
^
Start Date oo/oo/oo
Stop Date 00/00/00
Type
Reason
Eligible for Rehire A
Provide Details of Separation Below
Section 4 — Comments
Section 5 — Core Items (Current Data Required)
Item
Current Data
New Data
Dept# -Dept
Commissioners' Office-oollo1 ^
^ ^
Job# -Job Title
lot -18 -Deputy Clerk of the Board 2
-
Hire — Position
05/04/17 - o8/16/21
-
Grp# -Name
Nos -Non -Exempt
Employee Type
Full Time Regular
A
Section 6 — Secondary Items (Required only if Changing)
Item
Current Data
New Data
Base Wage
$30.75 Hourly
$31.57 Hourly
Band / Step
10/4
10/5
Stipend
$oo.0000 <Select Type>
$oo.0000 <Select Type>
Pay Type/FLSA
Non -Exempt — Salaried (SALYNE)
Non -Exempt — Salaried (SALYNE)
FTE
1.0 (4o hrs/wk)
1.0 (4o hrs/wk)
FTE—GrIS Only
<Enter>
<Enter>
Workweek
Standard Sun -Sat
Standard Sun -Sat
Section 7 - Authorizing Signatures
Department: Date:
Human Resources: t(, Date: ( J
Board Approval N Required ❑ Not Required
Chair:
Vice -Chair: Date:
Member:
no.;—A nisi c11011