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C1 <br />KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial <br />SECTION 1: EMPLOYEE DATA <br />LAST NAME <br />Dawson <br />FIRST NAME <br />Kim <br />EMPLOYEE # <br />D0137 <br />EFFECTIVE DATE <br />01/01/2017 <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) <br />❑ RESIGNATION (Q) <br />❑ RETIRED (R) <br />❑ LAID OFF (L) <br />❑ FAIL PROBATION (P) <br />❑ OTHER (0) <br />❑ PERFORMANCE (P) <br />❑ ATTENDANCE (A) <br />❑ CONDUCT (C) <br />❑ OTHER EMPLOYMENT (E) <br />❑ PERSONAL (L) <br />❑ OTHER (0) <br />❑ Eligible For Rehire ❑ Ineligible For Rehire <br />Provide Details of Separation Below <br />COMMENTS: Position's scale adjusted per BOCC and Sheriff, effective 1/1/17. New title is Office Administrator, with new occupation code <br />of 1313 and pay grade of 113. <br />SECTION 3: POSITION DATA <br />Enter existing data from CAMAS Wage Data Report <br />Enter new data <br />JOB TITLE <br />ADMINISTRATIVE ASSISTANT III <br />OFFICE ADMINSTRATOR <br />OCCUPATION CODE <br />3376 <br />1313 <br />UNION CODE <br />30 <br />30 <br />PAY GRADE <br />376 <br />113 <br />STEP / POSITION <br />9 <br />FLSA STATUS <br />❑ Non -Exempt [j] Exempt ❑ Not Covered <br />❑ Non -Exempt [j] Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible 0 PERS ❑ LEOFF ❑ PSERS ❑ Other <br />❑ Ineligible [D PERS ❑ LEOFF ❑ PSERS ❑ Other <br />HIRE DATE <br />11/1/1990 <br />ADJ HIRE DATE <br />11/1/1990 <br />POSITION DATE <br />1/1/2004 <br />LAST RAISE DATE <br />1/1/2016 <br />, <br />BASE WAGE <br />$4,371.00 <br />5 I p$ <br />LONGEVITY <br />$ 0.00 <br />$ <br />FTE <br />❑� 100% ❑ 80% [:175% ❑ 60% ❑ 50% <br />100% ❑ 80% [:175% ❑60% ❑ 50% <br />FTE WAGE <br />$4,371.004 <br />84$, _F01 09 <br />PAYMENT METHOD <br />❑ HOURLY ❑� MONTHLY <br />❑ HOURLY 5ONTHLY <br />DEPARTMENT <br />SHERIFF <br />BUDGET NUMBER <br />A. 001 000000000300151001 %: 100.00 <br />B. Yi: <br />A. %: <br />B. %: <br />WORKWEEK <br />0 Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />0 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 />OTHER (Detail in Comments Section) <br />$ 0.00 $ 0.00 <br />$ 0.00 $ 0.00 <br />SECTION 4: SIGNATURES (MUST BE SIGNED IN BLUE INK) <br />DEPARTMENT HEAD D OFFIC L <br />DATE <br />z$'? -)-7 <br />BUDGET/PAYROLL DATE <br />H <br />MAN RESOURCE <br />DATE <br />I #1 DATE <br />CO i <br />DATE <br />2-t J r l <br />WW <br />31N1551S7#3 \ U E <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBU iON <br />Updated: 04/08/11 FOR HR USE: NT Update EvalDate EvalRating(IE—ID—S—AA—S) Initial <br />