Fillable Change Of Status Form - Change of Status Form

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Change Of Status Form - Change of Status Form

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The Change Of Status Form - Change of Status Form form is 1 page long and contains:

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  • 28 check-boxes
  • 11 other fields

Country of origin: US
File type: PDF

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Notice of Employee Change of Status
Rhatigan Student Center
Employee’s Name: ___________________________________________ Effective Date: _________________
New Hire Resignation Promotion Salary Change
Rehire Termination Transfer ____________
Reason for Change: _________________________________________________________________________
Position Title: _____________________________________________________________________________
Keys/Company Property Issued: _______________________________________________________________
Salary: $__________ (hourly) $__________ (semi-monthly) Department Number: _________
Full Time (60500) Part Time (65300) Student (66100) Work Study (66300)
Termination Information:
Reason: Personal Misconduct Retirement
Reduction in Force No-Show __________________
Last Day of Work: _________________ Continue Direct Deposit or Hold Paper Check
⋅ Eligible for rehire in this department Yes No
⋅ Calling cards and keys turned in (if applicable) Yes No
⋅ Time card and RSC discount cards turned in Yes No
⋅ All issued company property turned in Yes No
______________________________________ ____________________________________
Supervisor Signature Director of RSC Signature
______________________________________ ____________________________________
Department Director Signature Director of HR Signature
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Change Of Status Form - Change of Status Form

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Completed 19 March 2020

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