Personnel Change Notice
Personnel Change Notice
Explanation________________________________
Employment
__New Hire __Rehired __Temporary __Part Time __Replacement For:
Termination
__Voluntary __Involuntary Last Day Worked Pay Through Rehire? __Y__N
Date
Hire Date Start Date Paid Days Accrued Severance Pay Approved?
__Y__N
Change
__ Rate/Salary __ Job __ Leave of Absence: From ___________ To __________
Location
Location Change To: From:
Comments
Approval Signatures
Prepared By: Date Supervisor: Date