"Employee Status Change Form"

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Employee Status Change Form
For new hires/transfers/promotions/additional positions/terminations
Please complete all that apply
1.
Employee Name
Employee#
2,
Check correct status
New Hire
Promotion
Transfer
Additional
Termination
2.
Current Position
3.
New/Additional Position
4.
Supervisor Name
5.
Complete GL number(s) to be charged
6.
Salary
7.Effective Date
7.
8. Office #____________________ 9. Grade_________________ 10. FTE________________________
Please submit completed form to VP of Strategic Human Resources for final authorization.
________________________________________
___________________________________________
Supervisor
Date
Departmental Vice President
Date
________________________________________
___________________________________________
Dr. Doreen Larson, President
Date
Linda Peltier
Date
Chief Human Resources Officer
To be completed by HR
[ ]
Exempt______ Nonexempt______ (check appropriate one)
Administrative____Professional Tech.____ Classified_____Faculty____(check appropriate one)
[ ]
HR employee orientation checklist/Checkout form
[ ]
Assign position (FACL)/Change (CPPI)/Salary(WAGS)/Additional(ADAP)/Terminate(TERM)
[ ]
Assign taxes (ETAX)
[ ]
Assign benefits (BNDS)
[ ]
Assign hours (PWSC)
[ ]
Assign/Adjust leave plans (LEVS/ACRS/LDTS)
[ ]
Check Model (MODL)
[ ]
Check EPOV screen for online access to pay advice
[ ]
Enter/Delete in Access (Edison Employee file)
[ ]
E-mail electronic account maintenance information
[ ]
Final payout to include vacation and sick (if applicable)
[ ]
If employee applies for or has medical coverage-send COBRA letter
[ ]
Salary Notification/Contract
[ ]
Create/change/pull personnel file
[ ]
Board approval (if applicable)
[ ]
Submit retirement paperwork to appropriate agency
[ ]
Notify Controller of status change
[ ]
Print Name badge
[ ]
Coffee Mug
Update web site – email K. Kiehl, copy A. Barr and A. Francis (include photo)
[ ]
[ ]
Update Compease Software
[ ]
Enter/delete benefits online at insurance carrier(s) websites
[ ]
Daily Update announcement
[ ]
Update organizational chart
Human Resources Forms 08/05/15
Employee Status Change Form
For new hires/transfers/promotions/additional positions/terminations
Please complete all that apply
1.
Employee Name
Employee#
2,
Check correct status
New Hire
Promotion
Transfer
Additional
Termination
2.
Current Position
3.
New/Additional Position
4.
Supervisor Name
5.
Complete GL number(s) to be charged
6.
Salary
7.Effective Date
7.
8. Office #____________________ 9. Grade_________________ 10. FTE________________________
Please submit completed form to VP of Strategic Human Resources for final authorization.
________________________________________
___________________________________________
Supervisor
Date
Departmental Vice President
Date
________________________________________
___________________________________________
Dr. Doreen Larson, President
Date
Linda Peltier
Date
Chief Human Resources Officer
To be completed by HR
[ ]
Exempt______ Nonexempt______ (check appropriate one)
Administrative____Professional Tech.____ Classified_____Faculty____(check appropriate one)
[ ]
HR employee orientation checklist/Checkout form
[ ]
Assign position (FACL)/Change (CPPI)/Salary(WAGS)/Additional(ADAP)/Terminate(TERM)
[ ]
Assign taxes (ETAX)
[ ]
Assign benefits (BNDS)
[ ]
Assign hours (PWSC)
[ ]
Assign/Adjust leave plans (LEVS/ACRS/LDTS)
[ ]
Check Model (MODL)
[ ]
Check EPOV screen for online access to pay advice
[ ]
Enter/Delete in Access (Edison Employee file)
[ ]
E-mail electronic account maintenance information
[ ]
Final payout to include vacation and sick (if applicable)
[ ]
If employee applies for or has medical coverage-send COBRA letter
[ ]
Salary Notification/Contract
[ ]
Create/change/pull personnel file
[ ]
Board approval (if applicable)
[ ]
Submit retirement paperwork to appropriate agency
[ ]
Notify Controller of status change
[ ]
Print Name badge
[ ]
Coffee Mug
Update web site – email K. Kiehl, copy A. Barr and A. Francis (include photo)
[ ]
[ ]
Update Compease Software
[ ]
Enter/delete benefits online at insurance carrier(s) websites
[ ]
Daily Update announcement
[ ]
Update organizational chart
Human Resources Forms 08/05/15

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