540
Job Title
ADP Position Number
Action
Hire/Rehire
Change
Separation
Leave of Absence
Return from LoA
Promotion/Reclass
FT Faculty Contract Type
Salary
Title
EFT
Home-Department
Supervisor
Chart String Coding
Resignation
Retirement
End of Contract
Discharge
Lack of Work
Death
Paid Leave
Unpaid Leave
Personal Leave
Military Leave (Documentation Required)
Medical Leave (Documentation Required)
Family Medical Leave (Documentation Required)
Faculty
Benefitted Bi-Weekly Staff
Administrative
Amount
Effective Date of Action
Employee Type
Home Department
Last Name
First Name
MI
SSN/ADP ID
Job Code / BCAT
Annual Salary
Hourly Rate
Semester Rate
Separation
Last Work Day
Leave of Absence (leave reports must be submitted accordingly)
Date Leave Begins
Approximate Return Date (return PAR required)
Acct
Comments
Fund
EFT (Class I only)
Action Initiated By
Phone
Date
Classes II and III are temporary employment only.
For Faculty and Administrative For Staff, SA, FWS, Casual Labor, SRAP For Class III Employees
Complete the following section for hire, change in status, or change of current information.
Hire:
Change:
P
ERSONNEL
A
CTION
R
EQUEST
Initial Hire at UWG
Rehire
also Employed at
Dept
Dept
Fund
Acct
Amount
Class I:
Class II:
Class III:
HR/Budget Use Only
HR Use Only
VPO
Budget Use Only ADP Payroll Distribution Code
ADP Supervisor
Supervisor’s ADP ID
Program
Class
Project
Program
Class
Project
Home Department ID
Student Assistant
Casual Labor
Federal Work Study
SRAP
Refresh Position
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Chart string(s) where expenditures occur:
Print on 4-part Reverse Paper only. May be ordered from Publications and Printing.
Class III requires a new PAR each semester.
Part-Time Faculty
Graduate Assistant
Resident Assistant
Pay Group
Required Approvals
:
All Classes: Department Approver Date
Biwkly/Admin Classification/Salary Review: HR Date
Class I & III in Academic Departments: Dean Date
Class I Hires/Promotions/Reclass: VP Date
Class I Hires/Promotions/Reclass: President Date
FWS: Financial Aid/Graduate Students: Graduate School Date
Budget Services Date
White: Payroll Yellow: Human Resources Pink: Budget Goldenrod: Department #06056 Human Resources 08/10
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