Fillable HUMAN RESOURCES ACTION FORM (Darton State College)

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HUMAN RESOURCES ACTION FORM (Darton State College)

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HUMAN RESOURCES ACTION FORM
1
HR Use Only
BCAT: _________________ Paygroup: ________ FICA Status ___________
DIST COPY: HR/PAYROLL/BUDGETS
Route to hrasu@asurams.edu
Please allow 7 – 10 business days for processing.
Effective Date
___/___/_____
Empl ID:
Empl Name:
Last First Middle
☐ New Position, or
Individual Replacing
Last First Middle
REQUESTED
ACTION
☐ Acct #
Change
☐ Dept.
Transfer
☐ Reports
To Update
☐ Pay
Change
☐ Title
Change
☐ Separation
Last Day
Worked
___/___/____
☐ Status
Change
Current Data
New Data
Account Number #1
Fund-Dept-Prgm-Class-Proj
Account Number #2
Fund-Dept-Prgm-Class-Proj
Salary
Position Title
Position Number
Department Name
Reports To (Supervisor)
Time Off Appr
EMPLOYMENT STATUS
☐ Full-time ☐ Part-time
☐ Full-time ☐ Part-time
☐ Regular ☐ Temporary
☐ Regular ☐ Temporary
Faculty
☐ 12 Mo Faculty ☐ 10 Mo Faculty ☐ PT Faculty
☐ 12 Mo Faculty ☐ 10 Mo Faculty ☐ PT Faculty
Staff
☐ Monthly ☐ Bi-Weekly
☐ Monthly ☐ Bi-Weekly
Student
☐ Federal Work Study ☐ Grad Asst
☐ Student Asst
☐ Federal Work Study ☐ Grad Asst
☐ Student Asst
Rehired Retirees
☐ Yes ☐ No
Non-Paid Affiliate
☐ Yes ☐ No
SIGNATURES
____________________________________________ _____________________________________________
Dept. Head/Dean Date Budgets Date
____________________________________________ _____________________________________________
Vice President/Provost Date Human Resources Date
____________________________________________
Signature – Title III (If applicable) Date
2
Reports To and Time Off Approver for Multiple Employees
Last Name
First Name
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HUMAN RESOURCES ACTION FORM (Darton State College)

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Completed 25 July 2020

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