Fillable PAYROLL CHANGE NOTICE (Pittsylvania County Virginia)

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PAYROLL CHANGE NOTICE (Pittsylvania County Virginia)

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The PAYROLL CHANGE NOTICE (Pittsylvania County Virginia) form is 1 page long and contains:

  • 3 signatures
  • 24 check-boxes
  • 41 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Pittsylvania County Virginia

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PAYROLL CHANGE NOTICE
Effective Date of
Change
Name
Employee #
EEOC Code
Department
Shift
FLSA Status
Full Time:
Part Time:
Exempt:
Non-exempt:
Temporary:
Permanent:
The Change(s):
✓ All Applicable Boxes
From
To
Department
Job
Shift
Rate
Address/Phone
Benefit Plan
Other:
Other:
The Reason for the Change(s):
Hired
Probationary Period Completed
Re-Hired
Length of Service Increase
Promotion
Re-evaluation of Existing Job
Demotion
Resignation
Transfer
Retirement
Merit Increase
Layoff
Wage Scale Change
Discharge
Leave of Absence From
Until
Type of Leave:
Other (Explain)
Authorization:
___________________________________________ ________________________________
Employee Signature Date
___________________________________________ ________________________________
Supervisor Signature Date
_________________________________________ ________________________________
Human Resources Manager Signature Date
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PAYROLL CHANGE NOTICE (Pittsylvania County Virginia)

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Completed 18 July 2020

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