Fillable Req Plus Guidelines060315 Form Fillable (California State University Channel Islands)

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Req Plus Guidelines060315 Form Fillable (California State University Channel Islands)

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EMPLOYEE REQUISITION/PERSONNEL ACTION REQUEST FORM
Please follow the Requisition Guidelines for assistance. Incomplete Requisitions will be returned to the Preparer and will delay requested transaction.
GENERAL INFORMATION
Date
Preparer’s Name
Department
Extension
Revised Requisition
Recruited Position
New Position Replacement Position: (Previous Incumbent)
PART I: EMPLOYEE INFORMATION
Employee Group:
Faculty MPP Staff
Employee ID#
Employee’s Legal Name Last, First, Middle Initial (Leave blank for Recruitment)
General Fund
Non-General Fund
Notes
PART II: ACTION REQUESTED – (Select ALL that apply) See Guidelines for definitions
Appointment
Temporary Appointment Concurrent
Extended Temporary Appointment
Retired Annuitant Appointment (Limited to 960 hrs per Fiscal year)
Reassignment (If temporary, include Ending Date below)
Emergency Hire
Time Base Change
Demotion
Reclassification
In-Range/In-Class Progression
Working Title Change
Supervisor Change
Stipend for:
CSUEU 5 CSUEU 7
CSUEU 9 SUPA 8
Effective Date of Action:
Ending Date (if temporary):
Explanation of Action:
PART III: POSITION/ASSIGNMENT INFORMATION
FROM
Current Assignment - Complete all Blocks
(Leave Blank for Recruitment)
TO
Proposed Assignment – Complete all Blocks
Home Dept Code
Home Department Name
Unit Code
Home Dept Code
Home Department Name
Unit Code
Class (Job) Code
Range or Grade
Position #
Class (Job) Code
Range or Grade
Position #
Classification Title
Classification Title
Working Title
Working Title
Reports to Administrator’s Name/Title (MPP)
Reports to Administrator’s Name/Title (MPP)
FTE/Time Base
Pay Plan
AC YR
10/12
FTE/Time Base
Pay Plan
AC YR
10/12
12 MO
11/12
12 MO
11/12
FT Monthly Salary Rate
$
Actual Salary Rate
$ Mo Hr
Stipend Amt
$ (Mo)
FT Monthly Salary Rate
$
Actual Salary Rate
$ Mo Hr
Stipend Amt
$ (Mo)
PART IV: SIGNATURES/APPROVALS (Complete only those required)
Name of Administrator/Title:
Signature:
Date:
Extension:
Name of Department/Division Director:
Signature:
Date:
Extension:
Name of Department Budget Officer:
Signature:
Date:
Extension:
Name of Vice President/Designee:
Signature:
Date:
Extension:
PART V: HR USE ONLY
Req #:
Reimbursed Moving Expenses(if applicable)
Maximum Amount Authorized - $
In-Class or Re-Class
Approved % :
Transfer of Credits from another State Agency:
Vacation: Data Transfer Form Received
Probationary Period
Permanency
MPP Job Code:
Documented by:
Begin:
End:
Date Eligible:
Initials:
Date:
Action Reason:
Tran Code:
Initial and Date
Log
HR Review
Recruiter
Payroll
Letter
HR Assistant
Data Entry
4/13/2015
California State University Channel Islands Requisition Form/Personnel Action Guidelines
General Information
Date
Date form is prepared
Preparer’s Name
The name of the person completing the requisition form
Department
Requesting Department
Extension
Telephone extension for the person completing the form
Revised Requisition
Check for revision or correction of an original requisition
Recruited Position
New or Replacement position that is recruited
Part I: Employee Information
Division
Requesting Division
Employee Group
Select appropriate employee group - Faculty/MPP/Staff
Employee ID #
Unique identification number
Employee’s Legal Name
Employee or selected applicant’s legal name
General Fund/Non-General Fund
Check the appropriate box
Notes
Additional information, if needed
Part II: Employee Information
Appointment
Initial hire to a recruited probationary/permanent position
Temporary Appointment
Initial hire to a recruited temporary appointment
Concurrent Assignment
Appointment to an additional, concurrent assignment
Extended Temporary Appointment
Extend an existing temporary appointment
Retired Annuitant Appointment
Appointment of a retired, former employee to an hourly position
Reassignment
Voluntary or management directed movement
Emergency Hire
Non-recruited appointment for a short-term position (60-90 days)
Time Base Change
A change in time-base. An increase may require recruitment
Demotion
Change in job classification with lower duties and salary range
Reclassification
A significant, permanent change in duties that results in a job code or
skill level change
In-Range/In-Class Progression
In-Range progression is an increase in salary within a salary range. In-
Class progression is movement from one skill level to a higher skill
level within a classification.
Working Title Change
Change of working title without change to current class code title
Supervisor Change
Change in Supervisor to whom an employee reports
Stipend
Indicate the unit for which a stipend payment will be made
Effective Date of Action and Ending Date
Date the requested assignment/action will begin and end (if temp)
Explanation of Action
For example - “Filling position vacated by XX”
Part III: Position/Assignment Information
Home Department Code
Code for Department that owns the position
Home Department Name
Name of Department that owns the position
Unit Code
Payroll Warrant Code
Class (Job) Code
CSU 4-digit classification code aka Job Code
Range or Grade
CSU specific range or grade for the class code
Position #
Position Number provided by Budget
Classification Title
CSU classification title
Working Title
Working title of the position
Reports to Administrator’s Name/Title
Must be MPP – Position who will approve Absence Management
FTE/Time Base
Time Base based on a Full-Time Equivalent (FTE) of 1.0
Pay Plan (Months Off for 10/12 & 11/12 Plans)
Identify two months off for 10/12 plans. Identify one month off for
11/12 plan. Check AC YR for Academic Year positions
FT Monthly Salary Rate
Monthly base salary
Actual Salary Rate
Actual salary adjusted by time-base. Monthly for salaried employees
and hourly for intermittent employees
Stipend Amount
Amount of monthly stipend
Part IV: Signatures/Approvals:
The names, title, and signature of the individuals authorized to approve the requested action
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Req Plus Guidelines060315 Form Fillable (California State University Channel Islands)

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Completed 20 July 2020

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