Laserfiche WebLink
' KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial <br />SECTION 1: EMPLOYEE DATA <br />LAST NAME <br />Horner <br />FIRST NAME EMPLOYEE # <br />Chris H2474 <br />SECTION 2: TYPE OF ACTION <br />EFFECTIVE DATE <br />1-1-17 <br />EMPLOYEE TYPE <br />EMPLOYEE ACTION <br />TYPE OF SEPARATION <br />REASON FOR SEPARATION <br />® 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 <br />❑ RE -HIRE <br />❑ MERIT/ STEP <br />❑ POSITION CHANGE (Describe Below) <br />❑ BUDGET CHANGE (Describe Below) <br />❑ LEAVE (List Type Below) <br />❑ TERMINATION (Provide Separation Info) <br />® OTHER (Describe Below) <br />❑ DISCHARGE (D) D PERFORMANCE (P) <br />❑ RESIGNATION (Q) ❑ ATTENDANCE (A) <br />❑ RETIRED (R) ❑ CONDUCT (C) <br />❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) <br />❑ FAIL PROBATION (P) ❑ PERSONAL (L) <br />❑ OTHER (0) ❑ OTHER (0) <br />❑ Eligible For Rehire ❑ Ineligible For Rehire <br />Provide Details of <br />Separation Below <br />COMMENTS: Increase per wage survey- effective 1-1-17; deferred to February payroll <br />SECTION 3: POSITION DATA <br />Enter existing data from CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />DPA II <br />OCCUPATION CODE <br />2315 <br />UNION CODE <br />30 <br />PAY GRADE <br />215 <br />STEP / POSITION <br />5 <br />FLSA STATUS <br />❑ Non -Exempt ® Exempt []Not Covered <br />❑ Non -Exempt Q <br />Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible PERS ❑ LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />9-3-13 <br />ADJ HIRE DATE <br />9-3-13 <br />POSITION DATE <br />9-3-13 <br />LAST RAISE DATE <br />1-1-16 <br />1-1-17 <br />BASE WAGE <br />$5115. <br />$6168. <br />LONGEVITY <br />$0 <br />$ <br />FTE <br />® 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />10 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE <br />$5115 <br />$6168. <br />PAYMENT METHOD <br />❑ HOURLY ® MONTHLY <br />❑ HOURLY 14 MONTHLY <br />DEPARTMENT <br />Prosecutor <br />BUDGET NUMBER <br />A.00129O351OO1 %:100 <br />B. %: <br />A. <br />B. <br />%: <br />%: <br />WORKWEEK <br />® Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />❑ 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) $0 <br />$ <br />STIPEND (Detail in Comments Section) <br />$0 <br />$ <br />OTHER (Detail in Comments Section) <br />$0 <br />$ <br />SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) <br />DEPARTME 0 / ELECTEDlffF.0 <br />DATE <br />7r <br />BUDGET/PA OL L <br />/_ <br />ATE <br />�!( IJ L. <br />HU E �' <br />RTE <br />COMM slulpify <br />CO 0 <br />DAT <br />y� f iE <br />CO DATE <br />2 <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 04/08/11 FOR HR USE: NT Update Eval Date EvalRating(IE— ID—S—AA—S) Initial <br />