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KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />Updated: 04/08/11 FOR HR USE: NT Update EvalDate E✓alRating (IE —ID—S—AA—S) Initial <br />SECTION 1: EMPLOYEE DATA <br />LAST NAME <br />FIRST NAME <br />EMPLOYEE # <br />EFFECTIVE DATE <br />MacDowell <br />Jonathan <br />M2497 <br />06/30/2014 <br />SECTION 2: TYPE OF ACTION <br />EMPLOYEE TYPE <br />EMPLOYEE ACTION <br />TYPE OF SEPARATION REASON FOR SEPARATION <br />❑ FULL-TIME (1) <br />LJ NEW HIRE <br />❑ DISCHARGE (D) ❑ PERFORMANCE (P) <br />❑ PART-TIME (2) <br />❑ RE -HIRE <br />❑ RESIGNATION (Q) ❑ ATTENDANCE (A) <br />❑ LIMITED PART-TIME (3) <br />❑ MERIT/ STEP <br />❑ RETIRED (R) ❑ CONDUCT (C) <br />❑ TEMPORARY (4) <br />0 POSITION CHANGE (Describe Below) <br />❑ LAID OFF (L; ❑ OTHER EMPLOYMENT (E) <br />❑ CASUAL (5) <br />❑ BUDGET CHANGE (Describe Below) <br />❑ FAIL PROBATION (P) ❑ PERSONAL (L) <br />❑ SEASONAL (6) <br />❑ LEAVE (List Type Below) <br />❑ OTHER (0) ❑ OTHER (0) <br />❑ PROJECT(7) <br />❑ TERMINATION (Provide Separation Info) <br />❑ Eligible For Rehire ❑ Ineligible For Rehire <br />❑� WORK STUDY (8) <br />❑ OTHER (Describe Below) <br />Provide Details of Separation Below <br />❑ VOLUNTEER (9) <br />COMMENTS: Move t0 paid position (still ftei+Vil credit at CWU) <br />�J <br />SECTION 3: POSITION DATA <br />u Enter existing data from CAMAS Wage Data Report Enter new data <br />JOB TITLE <br />VOLUNTEER / INTERN Office Assistant <br />OCCUPATION CODE <br />9900 3877 <br />UNION CODE <br />90 88 <br />PAY GRADE <br />900 377 <br />STEP / POSITION <br />1 4 <br />FLSA STATUS <br />❑� Non -Exempt ❑ Exempt ❑ Not Covered 0 Non -Exempt ❑ Exempt ❑ Not Covered <br />DRS STATUS <br />Q Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other Q Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />1/21/2014 <br />AD1 HIRE DATE <br />1/21/2014 <br />POSITION DATE <br />1/21/2014 6/30/14 <br />LAST RAISE DATE <br />BASE WAGE <br />$ 0.00 $ 10.00 <br />LONGEVITY <br />$ 0.00 $ <br />FTE <br />[E 100% [:180% ❑ 75% ❑ 60% ❑ 50% E 100% ❑ 80% ❑ 75% ❑ 60% [:150% <br />FTE WAGE <br />$ $10.00 <br />PAYMENT METHOD <br />Q HOURLY ❑ MONTHLY E] HOURLY ❑ MONTHLY <br />DEPARTMENT <br />COMMUNITY DEVELOPMENT SERVICES <br />BUDGET NUMBER <br />A. %. A, %: <br />B. %.- B. /: <br />WORKWEEK <br />Q Standard ❑ ALT/1" Friday off: ❑ 207(k) E] 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) $ 0.00 $ 0.00 <br />STIPEND (Detail in Comments Section) <br />$ 0.00 $ 0.00 <br />OTHER (Detail in Comments Section) <br />$ 0.00 $ 0.00 <br />SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) <br />DEPARTMENT HEAD / ELECTED OFFICIAL DATE BUDGET/PAYROLL DAT <br />t <br />- <br />HUMAN RESOURCE J <br />_ <br />DATE1 CO NER j' A t <br />In <br />COMN$(SSI N Rq2 @ / v DAT " n IrAT�' <br />1. <br />%�- <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 04/08/11 FOR HR USE: NT Update EvalDate E✓alRating (IE —ID—S—AA—S) Initial <br />