CREIGHTON UNIVERSITY HUMAN RESOURCES EMPLOYEE ACTION FORM 1/2017 Contact/ Extension: Date Prepared: Prepared by: Employee Name: Employee Number: Home Org Name: Org Number: Supervisor Name: Direct Reports: Sup Type of Effective Date: Action: Job Level & Title: Payroll Cycle: Assignment Category: Hours per week: Hours per year: If temporary or lecturer, indicate assignment end date: Rate of Pay: Per: Pay Reason: Last Day Worked: Return to Work Date: Effective date (must coincide with beginning of a pay Payroll Cycle: period unless hire/rehire action): Fund: Org: Account: Annual Amount: % Fund: Org: Account: Annual Amount: % Fund: Org: Account: Annual Amount: % Total: % Indicate additional costing details on an attached Payment Type: Explain reason for payment in comments section # Payments x Each Payment Amount: = Total Amount Pay Date for First Payment: Pay Date for Last Payment: Costing: Fund: Org: Account: % Fund: Org: Account: % Assignment # HR Use Only: O processed by: O processing date: BP: Administration: Status: Requisition # Differential Eligible Differential Rate: Working Title - Work Schedule PAYROLL Use Only:
CREIGHTON UNIVERSITY HUMAN RESOURCES EMPLOYEE ACTION FORM 1/2017 Date Prepared: Contact/ Prepared by: Extension: Employee Name: Employee Number: Org Number: Home Org Name: Supervisor Name: Direct Reports: Sup Type of Action: Effective Date: Job Level & Title: Payroll Cycle: Assignment Category: Hours per week: Hours per year: If temporary or lecturer, indicate assignment end date: Rate of Pay: Per: Pay Reason: Last Day Worked: Return to Work Date: Payroll Cycle: Effective date (must coincide with beginning of a pay period unless hire/rehire action): Fund: Org: Account: Annual Amount: % Fund: Org: Account: Annual Amount: % Fund: Org: Account: Annual Amount: % Indicate additional costing details on an attached Total: % Payment Type: Explain reason for payment in comments section # Payments x Each Payment Amount: = Total Amount Pay Date for First Payment: Pay Date for Last Payment: Costing: Fund: Org: Account: % Fund: Org: Account: % HR Use Only: Assignment # O processed by: O processing date: BP: Administration: Status: Requisition # Differential Eligible Differential Rate: Working Title - Work Schedule PAYROLL Use Only: