Employee Record Form
Effective Date
CARS ID #:
Last Name:
First Name:
FROM
Status
Full-Time
Part-Time
TO
Status
Full-Time
Part-Time
Exempt (Salaried)
Non-Exempt (Hourly)
Exempt (Salaried)
Non-Exempt (Hourly)
Regular
Temporary
Student
Casual
Schedule:
(Include %)
Regular
Temporary
Student
Casual
Leave of Absence
Acct. No:
Hrs/Wk:
Hrs/Wk:
Schedule:
(Include %)
Position No:
Job Grade:
Position No:
Job Grade:
Position Title:
Position Title:
Location:
Work Phone:
Location:
Work Phone:
Building Code:
Room #:
Building Code:
Room #:
Dept:
Dept:
Annual Salary: $
Hourly Rate: $
Annual Salary: $
Hourly Rate: $
Position Supervisor:
Position Supervisor:
(Please Print)
(Please Print)
eTime Supervisor:
(Please Print)
eTime Role
eTime Supervisor:
(Please Print)
eTime Role
CARS ID#:
CARS ID#:
Employee Only
eTime Supervisor
Manager*
Employee Only
eTime Supervisor
Manager*
*If Manager,
eTime Dept(s)
to Access:
*If Manager,
eTime Dept(s)
to Access:
APPROVAL SIGNATURES
VP/PROV. & Sr. VP:
Position Supervisor:
Date
Date
Dept. Head:
Budget Office:
Date
Date
Associate VP:
Human Resources:
Date
Please refer to instructions on reverse side. Please complete all pertinent information as per instructions.
Date
HRFERF 140102
TERMINATION
+
Last Day Worked:
Reason for Leaving:
Voluntary Involuntary
+
Employee Signature:
COMMENTS
*Temporary, Expected End Date:
New Hire
Replaces:
Print Form
Leave of Absence
Acct. No:
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
click to sign
signature
click to edit
EMPLOYEE RECORD FORM INSTRUCTIONS
This form is to be used for all new hires, status changes, leaves of absence, return from leave, and terminations. It
replaces the previous Payroll Authorization Form, Change of Status Form, and Termination Form.
COMPLETE EFFECTIVE DATE AND EMPLOYEE'S CARS ID# FOR ALL ACTIONS.
STATUS SECTION
NEW HIRE: Complete all information in the “FROM” column except the Termination section. Check the “New Hire” box in the Comments
section, and if a replacement, indicate former incumbent.
TRANSFER/PROMOTION/RECLASSIFICATION: Complete the “FROM” column showing all current employee information. Then
Complete the “TO” column showing all information that is changing. Indicate
reason for change (i.e., transfer, promotion, change from
full-time to part-time, reclassification, etc.) in the Comments box.
TERMINATION: Complete employee's Name and Status information in the “FROM” column. Then complete all information in Termination
box. Be sure to include the employee's actual last day worked. (The Effective Date of a termination will generally be the same as the Last
Day Worked.) If possible, have employee sign the form in the indicated area of the termination box.
LEAVE OF ABSENCE: When an employee goes out on a leave, complete employee's Name and Status information in the "FROM" column.
Then complete the Status information in the “TO” column, marking the Leave of Absence box. Record the Type of Leave i.e., FMLA,
personal, military, etc. in the Comments box and indicate the expected Return Date. The Effective Date should be the first work day the
employee is out of the office.
When an employee returns from a leave complete the employee's Name and Status information in the “FROM” column. Show the Status
the employee is returning to (i.e., Regular, Full-Time, and Non-
Exempt, etc.) in the “TO” column. Note “Return from Leave of Absence” in
the Comments box. The Effective Date is the date the employee returns to the office.
EMPLOYEE SALARY SPLIT BETWEEN MULTIPLE ACCOUNTS: Show all information for Status, Position, Location, etc. Then show the
Account Numbers and Percentage breakdown in the Comments box.
TEMPORARY EMPLOYEES: Complete all information in the “TO” column. Record the expected ending date of the temporary assignment
in the Comments box.
eTIME SUPERVISOR: An employee's eTime Supervisor is the person who establishes the work schedule and is responsible for approving
an employee's worked and non-
worked time in the eTime system. For hourly employees, this time refers to hours worked (timecard) and
paid time off requests. For salaried employees, this time refers to exception reporting and paid time off requests. Please note that the
eTime Supervisor is not required to be and is not necessarily the employee's Position Supervisor. In these cases, the eTime
Supervisor is acting as a proxy under the direction of the employee's Position Supervisor.
POSITION SUPERVISOR: The person directly responsible for conducting employee's performance appraisal and directing the
employee's work assignments.
eTIME SECTION
eTIME ROLE: The eTime Role section refers to the level of access in eTime assigned to each employee.
*EMPLOYEE ONLY: the employee will only be recording time for himself/herself.
*eTIME SUPERVISOR: the employee will be responsible for overseeing time reporting for others (may include
students). A Supervisor will only be able to access those employees de
signated with their Supervisor ID number. NOTE:
This role can be someone other than the position supervisor.
*MANAGER: the employee needs access to all employees within a certain department(s), indicate appropriate
department(s) in the corresponding box. A Manager will be able to access all employees in the designated
department(s), even those that have a Supervisor ID of another department member.