Fillable Personnel Action Form 1-2019 R8 (Montana Tech)

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Personnel Action Form 1-2019 R8 (Montana Tech)

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File type: PDF

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January 2019
Employee Name: Last First Middle Employee ID #
PERSONAL
INFORMATION
Department Campus Address (Building/Room #) Campus Phone
New Hire:
All new hires must report to HR on their 1st day.
CHANGE:
CLASSIFICATION
CONTRACT TYPE
Check one: CLASSIFIED or TEMP
Check one: PROFESSIONAL or FACULTY
FTE %:________
ASSIGNMENT
STATUS
Period of Appointment or Service: From: __________ To: ___________
Check All that Apply:
Compensation
Separation/Termination
NATURE OF ACTION Last Day Actually Worked:_____________
Change of Status
HR/PAYROLL OFFICE USE ONLY
Leave:
LEAVE
REPORTING/SUPERVISOR
INFORMATION
HR/PAYROLL OFFICE USE ONLY
SALARY Frequency:
INFORMATION
Compensation: Amount $ ______________
JUSTIFICATION OR
COMMENTS
Dept. Head/or Director Date VC of Administration & Finance Date
HR/PAYROLL OFFICE USE ONLY
Initial & Date:_____________
Position #:______________
EClass: _________________
Dean Date Director of Human Resources Date
Original: Payroll
cc:
HR Director
Budget Director
FTE %:________
MONTANA TECH
PERSONNEL ACTION FORM (PAF)
Reports to:_________________________Position#:__________________Title:_________________
From: _____________ to _____________
The state where
physically working
Termination
New Position
Part- Time Post Retiree
Replacement
Regular - Full-Time
Part-Time Regular, Limited to _____________ Hours
Part-Time-Occasional or Short-term Assignments
Academic Year
Academic Semester
Fall
Academic Year + 1
Summer
Spring
Fiscal Year
Appointment
Promotion/Rank Change
Leave with Pay
Reappointment
Leave without Pay with Benefits
Transfer
Sabbatical Leave
Leave without Pay No Benefits
Sick Leave
Vacation
Administrative Leave
Fall Semester
Spring Semester
Military Leave
FMLA
FMLA - Intermittent
Parental/Maternity
Foundation Supplements
Resignation
Retirement - Normal
Involuntary Termination
Retirement - Early
Another Job
During Probation Period
Health Reasons
Non-Renewal
For Cause
Moved
Reason Unknown
Other__________________
Deceased
One Payment
Hourly - Biweekly
12 Months
10 Months
Salary - BiweeklySemester
Salary - Monthly
Hourly - Monthly
New Hire/Replacement
Visiting
Change of Status
Compensation
Tenure
Other_______________
Temporary
Change of Status
Compensation
Full-Time
Part-Time Limited to _____________ Hours
Part-Time
Professional
North
C
a
mpus
Index
Percentage
Adjunct
Salary Adjustment
:
Proposed Title/Rank:___________________
_
_
EFFECTIVE/START DATE FOR THIS ACTION _____________
*Replacement for:_________________
Extra Compensation
Overload
Stipened
Merit
Compensation Agreement
Summer Comp
*
Letter of Appointment
Temp-Custodian
Te
mp-Dining Service
Temporary/Fixed
Term
Temporary/Part-Time
Classified
Faculty - Tenure Track
Temporary
Is Position Union Eligible?:
Yes
No
MUS Contract
BOR Contract
Highlands
Faculty - Non-Tenure Track
Visiting Professor/Inst (LOA)
Workman's Comp Classification:
High
Low
________________
_________________________________
____________________________________
cc:
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Personnel Action Form 1-2019 R8 (Montana Tech)

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Completed 25 July 2020

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