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KITTITAS COUNTY PERSONNEL ACTION FORM (PAFI <br />Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE -ID -S -AA -S) Initial <br />SECTION 1: EMPLOYEE DATA <br />LAST NAMEFIRST <br />Allphin <br />NAME <br />Reno <br />EMPLOYEE # <br />A0864 <br />EFFECTIVE DATE <br />-x/2013 <br />SECTION 2: TYPE OF ACTION <br />EMPLOYEE TYPE <br />EMPLOYEE ACTION <br />TYPE OF SEPARATION <br />REASON FOR SEPARATION <br />0 FULL-TIME (1) <br />❑ PART-TIME (2) <br />❑ LIMITED PART-TIME (3) <br />❑ TEMPORARY (4) <br />❑ CASUAL (5) <br />❑ SEASONAL (6) <br />❑ PROJECT (7) <br />❑ WORK STUDY (8) <br />❑ VOLUNTEER (9) <br />❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) <br />❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) <br />MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) <br />❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) <br />❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) <br />❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) <br />❑ TERMINATION (Provide Separation Info) <br />❑ OTHER (Describe Below) ❑ Eligible For Rehire U Ineligible For Rehire <br />Provide Details of Separation Below <br />COMMENTS: New Wage Scale adjust t0 midrange On new Scale. <br />SECTION 3: POSITION DATA <br />Enter existing data from CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />SOLID WASTE SPECIALIST <br />OCCUPATION CODE <br />2321 <br />UNION CODE <br />30 <br />PAY GRADE <br />221 <br />STEP / POSITION <br />5 <br />FLSA STATUS <br />❑ Non -Exempt E Exempt ❑ Not Covered <br />❑ Non -Exempt E] Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible Il PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible Q PERS E LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />12/18/1996 <br />ADJ HIRE DATE <br />12/18/1996 <br />POSITION DATE <br />4/3/2006 <br />LAST RAISE DATE <br />1/1/2013 <br />BASE WAGE <br />$ 3,703.00 <br />$ 3,999.00 <br />LONGEVITY <br />$ 0.00 <br />$ <br />FTE <br />F!] 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />E 100% ❑ 80% ❑ 75% ❑ 60% [150% <br />FTE WAGE <br />$3,703.00 <br />$3,999.00 <br />PAYMENT METHOD <br />❑ HOURLY ❑. MONTHLY <br />❑ HOURLY E MONTHLY <br />DEPARTMENT <br />SOLID WASTE <br />BUDGET NUMBER <br />A. 401 000000000040951001 %: 100.00 <br />B. %: <br />A. %: <br />B. %: <br />WORKWEEK <br />❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />I ❑ Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0". <br />ALLOWANCE (Detail in Comments Section) $ 25.00 $ 255.00 <br />STIPEND (Detail in Comments Section) <br />$ 0.00 <br />OTHER (Detail in Comments Section) <br />$ 0.00 $ 0.00 <br />SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) <br />DEPART.A(( NF_NT HEAD ELECTED OFFICIAL <br />ILA - <br />"`-, DATE, <br />BUDGET/PAYROLL DATE <br />zrONE <br />HUMAN RESOURCE <br />1DATt <br />Z2 <br />G # DATE <br />COI71I�115510 DATE ' <br />COMMISSEQ . R 'l7 1 <br />DATE <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBIDTION <br />Updated: 04/08/11 FOR HR USE: NT Update Eval Date Eval Rating (IE -ID -S -AA -S) Initial <br />