Employment Action Form

Employment EMPLOYEE NAME NEW REHIRE Department Action Form Position Start Date (NOTE: Terminations are processed using a separate form. INSTRUCTIONS: Complete ONLY the relevant sections. Attach all supporting documentation. RATE OF PAY: per hour or year STATUS: Probationary Regular Full Time* Part Time** (circle one) NOTE: ''Full Time'' is someone working 30 or more hours per week. ''Part Time'' is someone working less than 30 hours per week. Temporary TRANSFER/CHANGE Date: From: (department) (position) To: STATUS CHANGE CURRENT: Probationary Regular Temporary Effective Date: (month) 19 (year) Full Time* Part Time** CHANGE TO: Probationary Regular Temporary Full Time* Part Time** PAY CHANGE Current Rate of Pay: per hour Effective Date: (month) 19 (year) New Rate of Pay: or year (circle one) per hour or year (circle one) APPROVED BY: (Department Manager) (Director) (President/CEO) Human Resources American LegalNet, Inc. www.FormsWorkFlow.com 2001 © American LegalNet, Inc.