Laserfiche WebLink
C_` <br />KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />i <br />LAST NAME <br />Benner <br />EMPLOYEE TYPE <br />SECTION 1: EMPLOYEE DATA _ <br />FIRST NAMELOYEE # EFFECTIVE DATE <br />Chelsea B2658 01/01/2017 <br />r <br />SECTION 2: TYPE OF ACTION <br />EMPLOYEE ACTION TYPE OF SEPARATION REASON FOR SEPARATION <br />❑✓ FULL-TIME (1) ❑ NEW HIRE ❑ DISCHARGE (D) ❑ PERFORMANCE (P) <br />❑ PART-TIME (2) ❑ RE -HIRE ❑ RESIGNATION (Q) ❑ ATTENDANCE (A) <br />❑ LIMITED PART-TIME (3) ❑ MERIT/ STEP ❑ RETIRED (R) ❑ CONDUCT (C) <br />❑ TEMPORARY (4) ❑ POSITION CHANGE (Describe Below) ❑ LAID OFF (L) ❑ OTHER EMPLOYMENT (E) <br />❑ CASUAL (5) ❑ BUDGET CHANGE (Describe Below) ❑ FAIL PROBATION (P) ❑ PERSONAL (L) <br />❑ SEASONAL (6) ❑ LEAVE (List Type Below) ❑ OTHER (0) ❑ OTHER (0) <br />❑ PROJECT (7) ❑ TERMINATION (Provide Separation Info) <br />❑ WORK STUDY (8)✓❑ OTHER (Describe Below) ❑ Eligible For Rehire ❑ Ineligible For Rehire <br />❑ VOLUNTEER (9) Provide Details of Separation Below <br />COMMENTS: Increase per wage survey - payment effective 1/1/17; deferred until February payroll. <br />SECTION 3: POSITION DATA <br />Enter existing data from CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />PERMIT TECHNICIAN <br />OCCUPATION CODE <br />2441 <br />UNION CODE <br />40 <br />PAY GRADE <br />241 <br />STEP / POSITION <br />6 <br />FLSA STATUS <br />E] Non -Exempt ❑ Exempt ❑ Not Covered <br />0 Non -Exempt ❑ Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />12/7/2015 <br />ADJ HIRE DATE <br />12/7/2015 <br />POSITION DATE <br />12/7/2015 <br />LAST RAISE DATE <br />1/1/2016 <br />BASE WAGE <br />$ 3,256.00 <br />$ 3,583.00 <br />LONGEVITY <br />$ 0.00 <br />$ <br />FTE <br />❑' 100/ ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />[E 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE <br />$ 3,256.00 <br />$ 3,583.00 <br />PAYMENT METHOD <br />❑ HOURLY ❑' MONTHLY <br />❑ HOURLY ❑� MONTHLY <br />DEPARTMENT <br />COMMUNITY DEVELOPMENT SERVICES <br />BUDGET NUMBER <br />A. 402 000000104201051001 %: 100.00 <br />B. %: <br />A. %: <br />B. %: <br />WORKWEEK <br />[j] Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />S 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) <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 SIG IN BLUE INK) <br />TMENT O /ELECTED OFFICIAL <br />AAT <br />BUDGET/ AYROL DTE <br />H AN RESOURCE <br />DATE <br />COMM I ER 0 TE <br />=—qn <br />DATE <br />` i <br />CO SIO DATE <br />l — ~! / <br />4�rr6�elC2 <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 04/08/11 FOR HR USE: NT Update ____ Eval Date — Eval Rating (IE—ID—S—AA—S) Initial <br />