Fillable Status-change-form Employee Information

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Status-change-form Employee Information

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Country of origin: US
File type: PDF

U.S.A. forms for City

BROWSE CITY (AR) FORMS

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Revised December 2017
Employee Information
Employee ID:
Effective Date:
Process Level:
Department:
Employee Name:
Position No.
Grade:
Employee Status:
Job Title:
Immediate Supervisor Code:
Immediate Supervisor Name:
Please Check Reason for Status Change Below
USER LEVEL -
EXPENSE ACCOUNT -
ACTIVITY –
SALARY ADJUSTMENTS:
Merit Increase
Across the Board Increase
End of Probation
Salary Adjustment Not EPAS
Alternate Rate
Equity Review Increase
Range Minimum Adjustment
Minimum Wage Increase
Other: (explain)
Current Salary:
New Salary:
%
Of Increase
OTHER STATUS CHANGES:
Career Ladder
Transfer
Bumping Rights Exercised
Reclassification
Reorganization
Title Change Only
Suspension Without Pay
Suspension - Leave Substitute
60% Salary Continuation
Leave of Absence (State Reason)
Return from Leave of Absence
Disciplinary Demotion
Other: (explain)
TERMINATION:
Resigned
Disciplinary Action
Unsatisfactory Probation
Retirement
Disability
Death
Reduction in Work Force
End of Summer Program
End of Temporary Assignment
For Non-Probationary Post Hire Employees, Pre-Termination Hearing Date:
APPROVALS
Department Director
Date
Director of Human Resources
Date
City Manager
Date
STATUS CHANGE FORM
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Status-change-form Employee Information

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Completed 21 March 2020

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