Fillable FISK UNIVERSITY Personnel Action Change Notice (Fisk University)

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FISK UNIVERSITY Personnel Action Change Notice (Fisk University)

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The FISK UNIVERSITY Personnel Action Change Notice (Fisk University) form is 1 page long and contains:

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  • 20 check-boxes
  • 59 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Fisk University

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Revised 02/16
FISK UNIVERSITY
Personnel Action Change Notice
CHANGE INFORMATION: Check box(es) that apply.
Title
Pay _ ___ Per Hour Semester Semi-monthly
Annually
Department
Indicate the reason for the title, pay change and/or department change:
Promotion Merit/Salary Increase Salary Adjustment Transfer Separation
Other (Explain)
Classification FT PT Temporary Exempt Non Exempt Administrator Staff Support
(Check all that apply)
Tenured Tenure Track # ______ years ending academic year 200__ Non Tenured
Account/Budget Information
Effective date of acct # change: If applicable, ending date of acct # change:
APPROVAL SIGNATURES:
Date of Request:
Effective Date of Change:
Employee Name:
Position Title:
Department:
From:
To:
From: $
To: $
From:
To:
Provost’s Signature & Date: (If Academic Dept)
Dir. Sponsored Programs Signature: (If Applicable)
Bursar & Budget Director Signature & Date:
Chief Financial Officer Signature & Date:
Director of Human Resources Signature & Date:
Unrestricted Budget Account(s): (Fill in blanks for the appropriate account number to be charged for salaries)
#1100 - _ _ _ - 5001 Faculty #1100 - _ _ _ - 5002 Administrative #1100 - _ _ _ - 5003 Part Time
#1100 - _ _ _ - 5004 Union #1100 - _ _ _ - 5005 Maintenance #1100 - _ _ _ - 5008 Student (Undergrad)Non-tax
#1100 - _ _ _ - 5120 Student (Undergrad) Taxable #1100 - _ _ _ - 5121 Student (Grad) Non-tax
#1100 - _ _ _ - 5122 Student (Grad) Taxable #1100 - _ _ _ - 5123 Student (Foreign) Non-tax
#1100 - _ _ _ - 5124 Student (Foreign) Taxable #1100 - _ _ _ - 5125 Graduate Stipend
#1100 - _ _ _ - 5126 Undergraduate Stipend #1100 - _ _ _ - 5127 Adjunct Faculty
#1100 - _ _ _ - 5009 Temporary Agency #1100 - _ _ _ - 7020 Faculty Stipend
Percentage of salary to be charged to unrestricted Acct: _____ %
Restricted Budget Account(s): (Fill in blanks for the appropriate account number to be charged)
#_ _ _ _ - _ _ _ - _ _ _ _ Acct Name: _________________________ Percentage to be charged: _____ %
#_ _ _ _ - _ _ _ - _ _ _ _ Acct Name: _________________________ Percentage to be charged: _____ %
#_ _ _ _ - _ _ _ - _ _ _ _ Acct Name: _________________________ Percentage to be charged: _____ %
Please attach a separate sheet for any additional budget justifications or comments.
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FISK UNIVERSITY Personnel Action Change Notice (Fisk University)

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Completed 23 July 2020

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