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LAST NAME <br />Drain <br />KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />SECTION 1: EMPLOYEE DAIA <br />FIRST NAME EMPLOYEE # EFFECTIVE DATE <br />Andrew D1576 <br />COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll <br />1 X71 �t ;+i r3 yE.I�AlLtnet? _ hn OIWIIA.IkL. 1A <br />SECTION 2: TYPE OF ACTION <br />EMPLOYEE TYPE <br />EMPLOYEE ACTION <br />TYPE OF SEPARATION — <br />REASON FOR SEPARATION <br />Q FULL-TIME (1) <br />❑ NEW HIRE <br />❑ DISCHARGE (D) <br />❑ PERFORMANCE (P) <br />❑ PART-TIME (2) <br />❑ RE -HIRE <br />❑ RESIGNATION (Q) <br />❑ ATTENDANCE (A) <br />❑ LIMITED PART-TIME (3) <br />' ❑ 4kRIT/STEP <br />❑ RETIRED (R) <br />❑ CONDUCT (C) <br />❑ TEMPORARY (4) <br />❑ POSITION CHANGE (Describe Below) <br />❑ LAID OFF (L) <br />❑ OTHER EMPLOYMENT (E) <br />❑ CASUAL (5) <br />❑ BUDGET CHANGE (Describe Below) <br />❑ FAIL PROBATION (P) <br />❑ PERSONAL (L) <br />❑ SEASONAL (6) <br />❑ LEAVE (List Type Below) <br />❑ OTHER (0) <br />❑ OTHER (0) <br />❑ PROJECT (7) <br />1 TERMINATION (Provide Separation Info) <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ WORK STUDY (8) <br />O'l HER (Describe Below) <br />❑ Eligible For Rehire <br />❑ Ineligible For Rehire <br />❑ VOLUNTEER (9) <br />6/26/2007 <br />Provide Details ofSeparatian Below <br />COMMENTS: Increase per wage survey -payment effective 1/1/17; deferred until February payroll <br />1 X71 �t ;+i r3 yE.I�AlLtnet? _ hn OIWIIA.IkL. 1A <br />SECTION 3: POSITION DATA <br />Enter existing data corn CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />APPLICATION DEV MGR <br />OCCUPATION CODE <br />2330 <br />UNION CODE <br />30 <br />PAY GRADE <br />230 <br />STEP / POSITION <br />5 <br />FLSA STATUS <br />❑ Non -Exempt 0 Exempt ❑ Not Covered <br />❑ Non -Exempt 0 Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible Q PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />6/26/2007 <br />ADJ HIRE DATE <br />6/26/2007 <br />POSITION DATE <br />1/1/2016 <br />LAST RAISE DATE <br />1/1/2016 <br />Y <br />BASE WAGE <br />$5,208.00 <br />$5, 28.00 <br />LONGEVITY <br />$ 0.00 <br />$ <br />FTE <br />2 100% ❑ 80% ❑ 75% [160% ❑ 50% <br />❑ 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE <br />$5,208.00 <br />$5,728.00 <br />PAYMENT METHOD <br />❑ HOURLY ❑� MONTHLY <br />❑ HOURLY 2 MONTHLY <br />DEPARTMENT <br />INFORMATION TECHNOLOGY <br />BUDGET NUMBER <br />A. 001 000000000001751001 %: 100.00 <br />A. %: <br />B. %: <br />B. %: <br />WORKWEEK <br />EStandard ❑ ALT/1" Friday off: ❑ 207(k) <br />E Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />To continue any allowance, stipend, or other, it must be listed in both columns for audit purposes or the amount will default to "0", <br />ALLOWANCE (Detail in Comments Section) <br />$ 60.00 <br />$ 60.00 <br />STIPEND (Detail in Comments Section) <br />$ 0.00 <br />$ 0.00 <br />OTHER (Detail in Comments Section) <br />$ 0.00 <br />$ 0.00 <br />SECTION 4: SIGNATURES (MUST BE SIGNERA <br />BLUE INK) <br />DEPARTMENT- FFICTAL _ <br />- <br />DATE <br />BUDGET/P YAOLL <br />DATE <br />_ <br />rr'' HUMAN RESOURCE <br />AT£ <br />COMM <br />DATE <br />L~ � <br />VDE, <br />CO M1SJ <br />DATE1 <br />COM NE <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 04/08/11 FOR HR USE: <br />NT Update EvalDate <br />Eval Rating (IE—ID—S—AA—S) Initial <br />