Empl ID or SS# if New Hire: HUMAN RESOURCES Personnel Action Form Date Prepared: Hire/Rehire Preparer’s Name: PERSONAL DATA Prefix First Name M.I. Last Name Suffix Street Address City State Postal Code JOB DATA Start Date End Date (if temp) Action Reason Fac Tenure Elig Date Job Req # Position # (reg) New or Indicate Previous Incumbent Job Function Job Family Campus and Department Temp/Reg Full Time/ Part Time Standard Hours Primary Title Secondary Title(s) COMPENSATION Current information Current information Resource Analysis & Budgeting : Base Contract Rate If applicable please indicate the additional funding Contract Basis source(s) other than or in addition to originally Grade approved budget: Account - % Bargaining Unit Account/Position Number Amount Admin stipends: Stipend Amount: Account - Stipend Basis: %: EMPLOYMENT DATA Building/Room Campus Phone Campus Zip+4 First Level Supervisor COMMENTS OR CONTINGENCIES Note: Faculty hires please attach a copy of the JRF/SPRC Rationale, Candidate Interview Summary, signed letter of offer, resume, original transcripts, and (if applicable) Search Waiver. SIGNATURE APPROVALS Department Chair/Director Date Dean Date Vice President/Provost/President Date Appointing Authority Date HUMAN RESOURCES USE ONLY In HR BOT Date Proc. By Prob End Fair Sh. To RPBB Ret Sys Job Code SPRC Approval Budget Funds Available Controller Funds Available _________________________________________ Date______________ _________________________________________ Date______________ HRF001 Revised 8/8/2016
HUMAN RESOURCES Personnel Action Form Hire/Rehire Empl ID or SS# if New Hire: Date Prepared: Preparer’s Name: PERSONAL DATA Prefix First Name M.I. Last Name Suffix Street Address City State Postal Code JOB DATA Start Date End Date (if temp) Action Reason Fac Tenure Elig Date Job Req # Position # (reg) New or Indicate Previous Incumbent Job Function Job Family Campus and Department Temp/Reg Full Time/ Part Time Standard Hours Primary Title Secondary Title(s) COMPENSATION Current information Current information Resource Analysis & Budgeting : Base Contract Rate Account - % If applicable please indicate the additional funding source(s) other than or in addition to originally approved budget: Contract Basis Grade Bargaining Unit Account/Position Number Amount Admin stipends: Amount: Stipend Account - %: Stipend Basis: EMPLOYMENT DATA Building/Room Campus Phone Campus Zip+4 First Level Supervisor COMMENTS OR CONTINGENCIES Note: Faculty hires please attach a copy of the JRF/SPRC Rationale, Candidate Interview Summary, signed letter of offer, resume, original transcripts, and (if applicable) Search Waiver. SIGNATURE APPROVALS Department Chair/Director Date Dean Date Vice President/Provost/President Date Appointing Authority Date HUMAN RESOURCES USE ONLY In HR BOT Date Proc. By Prob End Fair Sh. To RPBB Ret Sys Job Code SPRC Approval Budget Funds Available _________________________________________ Date______________ Controller Funds Available _________________________________________ Date______________ HRF001 Revised 8/8/2016
HRF001%20Hire_Rehire%20PAF.docx