Laserfiche WebLink
tt% KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />LAST NAME <br />Nuffer <br />SECTION 1: EMPLOYEE DATA <br />FIRST NAME EMPLOYEE # EFFECTIVE DATE <br />Kim N1908 02/17/2017 <br />SECTION 2: TYPE OF ACTION <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) ❑ 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 Separation Below <br />COMMENTS. <br />SECTION 3: POSITION DATA <br />Enter existing data from CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />DEPUTY CLERK <br />OCCUPATION CODE <br />3245 <br />UNION CODE <br />20 <br />PAY GRADE <br />345 <br />STEP / POSITION <br />7 <br />FLSA STATUS <br />Q Non -Exempt ❑ Exempt ❑ Not Covered <br />Q Non -Exempt ❑ Exempt ❑ Not Covered <br />DRSSTATUS <br />Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑Other <br />HIRE DATE <br />12/11/2006 <br />ADJ HIRE DATE <br />12/11/2006 <br />POSITION DATE <br />12/11/2006 <br />LAST RAISE DATE <br />12/1/2012 <br />BASE WAGE <br />$ 3,304.00 <br />$ 0.00 <br />LONGEVITY <br />$45.00 <br />$ <br />FTE <br />Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />[j] 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE <br />$3,304.00 <br />$ <br />PAYMENT METHOD <br />❑ HOURLY ❑� MONTHLY <br />❑ HOURLY F MONTHLY <br />DEPARTMENT <br />CLERK <br />BUDGET NUMBER <br />A.001 000000000159951001 %: 62.00 <br />B. 001 000000000001951001 %: 38.00 <br />A. <br />B. i s <br />WORKWEEK <br />F Standard ❑ ALT/1" Friday off: E1207(k) <br />E Standard ❑ ALT/1" Friday off: E1207(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) <br />$ 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 />UFPAH THE / ELECTED <br />FICIAL DAT <br />17 <br />BUDGET/PAYk ATF <br />COMMISSIO 3 DATF <br />HUMAN RESOURCE <br />DAT <br />C I It <br />DATE <br />COMMIS 1r l7 E <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 04/08/11 FOR HR USE: <br />NT Update Eval Date Eval Rating (IE — ID — S — AA — S) Initial <br />