Laserfiche WebLink
KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />LAST NAME <br />Stafford <br />SECTION 1: EMPLOYEE DATA <br />FIRST NAME EMPLOYEE # EFFECTIVE DATE <br />Michael S1503 01/01/2017 <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 />�] 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: Increase per wage survey -payment effective 1/1/2017; 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 />JUVENILE COURT ADMINISTRATOR <br />OCCUPATION CODE <br />2327 <br />UNION CODE <br />30 <br />PAY GRADE <br />227 <br />STEP / POSITION <br />5 <br />FLSA STATUS <br />❑ Non -Exempt I] Exempt ❑ Not Covered <br />❑ Non -Exempt (] Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible ❑ PERS ❑ LEOFF [j] PSERS ❑ Other <br />❑ Ineligible ❑ PERS ❑ LEOFF [j] PSERS ❑ Other <br />HIRE DATE <br />1/27/2003 <br />ADJ HIRE DATE <br />1/27/2003 <br />POSITION DATE <br />9/2/2015 <br />LAST RAISE DATE <br />1/1/2016 <br />r <br />BASE WAGE <br />$ 5,430.00 <br />$ 5,973.00 <br />LONGEVITY <br />$ 0.00 <br />$ <br />FTE <br />❑� 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />Q 100% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE <br />$ 5,430.00 <br />$ 5,973.00 <br />PAYMENT METHOD <br />❑ HOURLY ❑� MONTHLY <br />❑ HOURLY Q MONTHLY <br />DEPARTMENT <br />JUVENILE PROBATION <br />BUDGET NUMBER <br />A. 001 000000000220151001 %: 100.00 <br />B. %: <br />A. %: <br />B. %: <br />WORKWEEK <br />0 Standard ❑ ALT/1" Friday off: ❑ 207(k) <br />I 0 Standard ❑ ALT/1" Friday off: _ ❑ 207(k) <br />To continue any allowance, stipend, <br />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 <br />$ 0.00 <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 SIGNED IN BLUE INK) <br />A T D / ELfETED OFFICIAL DATE <br />17 <br />BUDGET/PAY OCL] �'TE <br />HU AN RESOURCE <br />I7 -1-77 - <br />COMMIS DA <br />A; <br />CO ER <br />DATE <br />COMM{ s TE <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 />