Fillable Personnel Action Notice Form3.2020 (City of Gulfport Mississippi)

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Personnel Action Notice Form3.2020 (City of Gulfport Mississippi)

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The Personnel Action Notice Form3.2020 (City of Gulfport Mississippi) form is 1 page long and contains:

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  • 19 check-boxes
  • 54 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Gulfport Mississippi

BROWSE CITY OF GULFPORT MISSISSIPPI (MS) FORMS

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H.R. Form Revision 3/2020
PERSONNEL ACTION NOTICE FORM
Date:
Social Security #:
Department:
*Location in Dept:
*KRONOS Manager:
Name:
Date of Birth:
(Last name)
(First name)
Address:
City:
State:
Zip:
Phone #:
Effective
Date:
Employment
Date:
Sex (M or F):
Computer Usage – Login - Email - Munis - TCM Production -
TYPE OF ACTION
TYPE OF
CHANGE
(HR CODES)
New Hire
Return from Layoff
Salary Change
EEOC:
Transfer
Rehire
Grade/Step
LOA
Promotion
Job Title
WCC:
Termination
Layoff
Department
Return from LOA
Retirement
Status
MISC.
EMPLOYMENT / CHANGE INFORMATION
Status
(FT/PT/
TEMP)
Job Title Grade/
Step
Rate
of Pay
% Of
Increase
Exempt /
Non-
Exempt
Date of
Review
Review
Rating
Salary
Change
Code
Effective
Date
New
Current
Remarks:
TERMINATION / LAY-OFF / LEAVE OF ABSENCE
Term
Code:
Term.
Date:
Rehire:
Yes
No
Vacation
Payout:
LOA
Code:
Begin
Date:
Return
Date:
Number
of days:
ATTACH RESIGNATION LETTER, REQUEST FOR LOA, OR TERMINATION DOCUMENT, ETC.
Reason:
EMPLOYEE SIGNATURE: ______________________________________________ Date: ________________________
MAN
AGEMENT SIGNATURE: ___________________________________________Date: ________________________
APP
ROVED BY: _______________________________________________________ Date: ________________________
HUMAN R
ESOURCES: __________________________________________________ Date: ________________________
CODES
TERMINATION CODES EEOC CODES
SALARY CHANGE
CODES
REVIEW RATINGS LOA CODES
14B - Other Employment
14C - Comp./Benefits
14D - Health
14E - Personal
14F - Family
14G - Relocation
14H - Return to school
14I - Hours/Shift
14J - Conflict
14K - Failure to return from LOA
14L - Temporary/Casual
14 N- Deceased
14O - Retirement
24B - Unsatisfactory Performance
24C - Attendance/Tardiness
24D - Dishonesty
24E - Insubordination
24F -
Failure to comply with
company policy
24G - Misconduct
24H - Abandoned job
24I - Lay-off
24J- Other
01 - White
02 - Black
03 - Hispanic
04 - Asian/ Pac. Island
05 - American
Indian/Alaskan
B - Below min. market adj.
D - Decrease
H - Shift Change
J - Job Change
M - Merit
N - New Hire
O - Organizational Change
P - Promotion
X - Other
X - Excellent
E - Exceed Standards
M - Meets standards
B - Below Standards
U - Unsatisfactory
121 - Military
122 - Medical
123 - Personal
Employee #
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Personnel Action Notice Form3.2020 (City of Gulfport Mississippi)

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Completed 14 July 2020

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