CITY OF HICKORY
PAYROLL CHANGE NOTICE
Employee Name: ___________________________________ Effective Date (must be beginning of a pay period):
Department/Division: _______________________________ _______________________________
A. Action To Be Taken:
_____Enter on Payroll ___Change Current Status ___Remove From Payroll
Last day paid: _____________________
B. New Hire or Status Before Change:
St
atus After Change:
C. Reason for Change: Employee Worked Full Notice Per Personnel Policy
Reason for Remove from Payroll: Yes_____ No_____
_____Resigned/Quit Vacation Hours to be Paid: ____________
_____Retired Comp Time Hours to be Paid: ____________
_____Terminated Sick Leave Balance: ____________
Reason for Change (Other than New Hire or Remove from Payroll)
_____Promotion
_____Change of Scheduled Hours
_____Demotion
_____Lateral Transfer
Other: ________________________
Transferring Department Date
Department must contact the IT Help Desk for
new employee technology requirements (phone
and email, etc.) and when employee leaves
employment (passwords, email, return of items)
Completed Not Applicable
