Arizona State Personnel System
INTER-AGENCY TRANSFER REQUEST FORM
Submit this completed form to Interagency.Transfers@azdoa.gov
ALL INCOMPLETE FORMS WILL BE RETURNED TO THE AGENCY AND NOT PROCESSED
EIN
Employee Name
(Last, First, MI)
Effective Date
of Transfer
Last Day Worked
for Losing Agency
LOSING AGENCY INFORMATION
Agency
Name
Agency Code
Status
• Time Records and Close-out Performance Evaluations are required.
• Information required to complete this form can be located on HRIS
Screen ZH11.
• The agency is responsible for entering any remaining time records for the
employee by the close of business on the last day the employee worked for
the agency.
• The agency MUST NOT enter a separation action for the employee
unless the employee has a break in employment not covered by
approved leave. Moving from one agency to another agency does not
constitute a resignation from State employment.
• The agency provides the official personnel file of the employee to the
Gaining Agency within 20 days from the effective date of the employee's
transfer.
• Close-out performance evaluations are required for all active State
Personnel System employees who transfer to another agency.
GAINING AGENCY INFORMATION
Agency
Name
• The Agency must ensure the information attached to the position (Job
Code, Process Level, and Expense Account Information) is correct and
active.
• The Agency submits the Inter-Agency Transfer Request Form to the ADOA
HRIS Inter-Agency Transfer Coordinator as soon as the agency
knows the
effective date for the transfer.
• The agency will receive notice of the completed transfer via an e-mail from
the Inter-Agency Transfer Coordinator.
• The agency enters a Job Change action on the Individual Action Form
(XP52.1) screen after the transfer has been completed and updated in
HRIS by the Inter-Agency Transfer Coordinator.
• The agency enters a REHIRE1 action on the Individual Action Form
(XP52.1) for any separated employee.
• The agency is responsible for contacting the Losing Agency to obtain the
employee's official personnel file from the Losing Agency.
Gaining Agency Contac
t Name
Gaining Agency
P
hone Number
ASPS/HRD -FA3.16 01/28/19
LOSING AGENCY REQUIREMENTS:
Agency Code
Position Number
S
tep - only applies to ADC and SD
GAINING AGENCY REQUIREMENTS:
Gaining Agency
Contact Email
ADOA HRUSE ONLY
Date Processed by ADOA HRIS Inter-Agency Transfer Coordinator
Remove ETE Proxy - ZS01
Remove Losing Agency E
mail
Remove Driver Flag
Email completed forms to:
• ADOA Benefits
• Interagency.Transfers@azdoa.gov
• Gaining Agency
• Losing Agency
• I9help@azdoa.gov
ASPS/HRD - FA3.16 6/19
