Fillable Victory Programs Personnel Action Form

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Victory Programs Personnel Action Form

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The Victory Programs Personnel Action Form form is 1 page long and contains:

  • 0 signatures
  • 27 check-boxes
  • 66 other fields

Country of origin: OTHERS
File type: PDF

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Victory Programs Personnel Action Form
Rehire Change
Term
New Hire
Employee Name
Program
Supervisor’s Name
Effective Date
To:
New Hire
GL#
Position
Secondary Position
Position
Salary $
Next review date
Program
GL#
Scheduled hours per week
Termination
Resigned
Discharged
Laid-off
Other:
Eligible for rehire? Yes
No
Conditional Reason
Exit interview done: Yes
No
Entered into HR Database Date
Submitted to Payroll
Date
Date
Has all property been received?
Yes
No
Reason for Termination
Relief
City:
Phone Number
DOB
SSN
Salary/Wage $
Eligible for benefits (20+ hrs/wk)
Scheduled hours per week
Mailing address: Street:
State
Zip Code
Gender
Employment Status Change
Position
position title
dept.
Inactive
Full Time
Non Exempt
From:
Change address and/or phone number (please use space provided in the New Hire section)
Internal Transfer( please use space provided below)
Change position from
dept.
dept.
dept.
position title
position title
to
New GL #
Benefit Status Change
Yes
to
to
Change Position to
Change budgeted hours from
Change program/dept. from
Change Salary/wage from
Change Marital Status from
to
____________\
No
to
Reason
Next Review Date
Change Name to
dept.
position title
position titleposition titleposition title
Part Time
Exempt
Program Director SignatureProgram Director Signature
Program Director (print)
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Date
Personnel Action Form v2021.11
Active
Cost Center
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Victory Programs Personnel Action Form

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Completed 29 June 2022

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