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,.. KITTITAS COUNTY PERSONNEL ACTION FORM (PAF) <br />SECTION 1: EMPLOYEE DATA <br />.FL A:S:T NAME <br />ADAMS <br />FIRST NAME <br />CYNTHIA <br />EMPLOYEE # <br />Al 161 <br />EFFECTIVE DATE <br />2/01/ 10 <br />SECTION 2: TYPE OF ACTION <br />EMPLOYEE TYPE <br />EMPLOYEE ACTION <br />TYPE OF SEPARATION <br />REASON FOR SEPARATION <br />®FULL-TIME (l) <br />❑ PART-TIME (2) <br />❑ LIMITED PART -TIM.E (3) <br />❑ TEMPORARY ('4) <br />❑ CASUAL (5) <br />❑ SEASONAL (6) <br />I ❑ 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 />❑ 'TTRMINATION (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 />0 ATTENDANCE (A) <br />❑ CONDUCT (C) <br />❑ OTHER EMPLOYMENT (E) <br />❑ PERSONAL (L) <br />❑ OTHER (0) <br />; <br />❑ Eligible For Rehire ❑ Ineligible For Rehire <br />Provide Details of Separation Below <br />COMMENTS (include work schedule if position is less than full-time): MERIT INCREASE; 4.8% <br />SECTION 3: POSITION DATA <br />Enter existing data from payroll system Enter new data to he input into payroll system. <br />JOB TITLE <br />ADMINISTRATIVE ASSIST III <br />� <br />OCCUPATION CODE <br />3376 <br />UNION CODE <br />30 <br />PAY GRADE_ <br />376 <br />STEP / POSITION <br />5 <br />FLSA STATUS <br />°-Non-Exempt K4xempt ❑ Not Covered <br />❑ Non-Exempt ❑ Exempt ❑ Not Covered <br />DRS STATUS <br />❑ Ineligible ® PERS ❑ LEOFF ❑ PSERS <br />❑ Ineligible ❑ PERS ❑ LEOFF ❑ PSERS <br />HIRE DATE <br />2/11/98 <br />ADJ HIRE DATE <br />2/11/98 <br />POSITION DATE <br />1/30/07 <br />LAST RAISE DATE <br />5/1/09 <br />2/01/10 <br />BASE WAGE <br />$3300 <br />$3458 <br />LONGEVITY <br />$0 <br />$0 <br />FTE <br />® ion. ❑ go% ❑ 75% ❑ 60% ❑ 5001. <br />❑ I00% ❑ 80% ❑ 75% ❑ 60% ❑ 50% <br />FTE WAGE (Calculate If FTE < 100%) <br />$0 <br />$0 <br />PAYMENT METHOD <br />0 HOURLY ❑ MONTHLY ❑ DAILY <br />❑ HOURLY ❑ MONTHLY ❑ DAILY <br />DEPARTMENT <br />ASSESSOR <br />BUDGET NUMBER <br />A. 1-1051.001 A. 100% <br />B. B, ado <br />A. A. % <br />B. B, % <br />WORKWEEK <br />® Standard ❑ Alternate ❑ 207(k) exception <br />❑ Standard ❑ Alternate ❑ 207(k) exception <br />ALLOWANCE (Detail in Comments Section) <br />$0 <br />$0 <br />STIPEND (Detail in Comments Section) <br />$0 <br />$0 ! <br />OTHER (Detail in Comments Section) <br />$0 <br />$0 <br />SECTION 4: SIGNATURES MUST RE_$jGNU IN BLUE INK{ <br />DE7PP � MENT HEAD F ELECTED O FICIAL DATE <br />if d . -1 <br />BUDGETIPAYR LL DATE <br />° �� I1. <br />A ESO JR, C �. / DATE <br />COMMISSICYNE #1 AT <br />col, ISSIONE:R #2 eFE <br />COMMISSIONER #3 DATE <br />RETURN FORM TO HUMAN RESOURCES FOR DISTRIBUTION <br />Updated: 08/27/07 FOIL FIR USE: PAF Log NT Update Eval Dato% 10 Eval Rating (]E — ID — S -(A� S) nitiay� <br />