Employee Action Authorization University Enterprises, Inc. Human Resources (916) 278-7003 This form must be completed and signed by an authorized individual, and presented by the employee at orientation. Name and Social Security Number must appear exactly as shown on valid Social Security Card. Last Name First Middle Name Employee ID Social Security Number Name Number Effective Date OF Rate Change Address Change Account Number New Hire Name Change Other Change(s) Re-Hire REQUIRED ON ALL Reclassification Explain in TRANSACTIONS (Rate Changes require an “comments” Complete Section 1 Complete section 2 effective date of the 1st or Section 2 Complete entire form 16th of the month) Current Address - Other Information appears on W-2 forms and Pay STREET APT # ADDRESS ( ) CITY STATE ZIP ( ) OTHER PHONE HOME PHONE Employee Ethnicity Birthdate Male Female Employment is dependent on the mutual consent of University Enterprises and yourself, and either University Enterprises or you 1 can, at any time, terminate the employment relationship at will, with or without cause. Employee Signature Date Daytime SECTION Agency/Dept Employee Job Title Worksite City Current Sac State Full-Time Employee Posting Number Account Number Changes Add Additional Account (only when necessary) - UEI Account # Delete Account Transfer From Acct.# Account Object code Timekeeping Code - (if known) Acct/Timekeeping Code OBJ Code Manager PayRate Per Week per hour Hours / Comments: Supervisor PRINTED NAME CONTRACT MANAGER / PROJECT DIRECTOR E-MAIL ADDRESS PHONE 2 PRINTED NAME OF SUPERVISOR E-MAIL ADDRESS PHONE x SECTION AUTHORIZED SIGNATURE DATE University Enterprises use only Student/Graduate Assistant Orientation Date Casual not to exceed 19.5 hours per week (non-student/on-campus depts. only) – Other Entered By Date
Employee Action Authorization University Enterprises, Inc. Human Resources (916) 278-7003 This form must be completed and signed by an authorized individual, and presented by the employee at orientation. Name and Social Security Number must appear exactly as shown on valid Social Security Card. Last Name First Name Middle Name Employee ID Number Social Security Number Effective Date Rate Change Account Number Change(s) Reclassification Complete section 2 Address Change Name Change Complete Section 1 Other Explain in “comments” Section 2 REQUIRED ON ALL TRANSACTIONS (Rate Changes require an effective date of the 1st or 16th of the month) New Hire Re-Hire Complete entire form SECTION 1 Employee Current Address - appears on W-2 forms and Pay STREET APT # CITY STATE ZIP ( ) HOME PHONE Other Information ADDRESS ( ) OTHER PHONE Male Female Ethnicity Birthdate Employment is dependent on the mutual consent of University Enterprises and yourself, and either University Enterprises or you can, at any time, terminate the employment relationship at will, with or without cause. Employee Signature Date Daytime SECTION 2 Supervisor / Manager Agency/Dept Employee Job Title Worksite City Current Sac State Full-Time Employee Posting Number Account Number Changes Add Additional Account (only when necessary) UEI Account # - Delete Account Account Object code Timekeeping Code (if known) Transfer From Acct.# - Acct/Timekeeping Code OBJ Code PayRate per hour Hours Per Week Comments: PRINTED NAME OF CONTRACT MANAGER / PROJECT DIRECTOR E-MAIL ADDRESS PHONE PRINTED NAME OF SUPERVISOR E-MAIL ADDRESS PHONE x AUTHORIZED SIGNATURE DATE University Enterprises use only Student/Graduate Assistant Casual (non-student/on-campus depts. only) – not to exceed 19.5 hours per week Other Orientation Date Entered By Date
HR_eaa.docx