Personnel Change Notice
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Like it never even happened® Fire & Water – Cleanup & Restoration™
Personnel Change Notice __ Employment __ Terminate __ Change Explanation________________________________ Employee
Employee #
Address
City
Job Title
Start Date
Location
__Temporary __Part Time Age
Sex
Last Day Worked
Hire Date
Paid Days Accrued
Change __ Rate/Salary __ Job __ Location Location Change
Phone
Education
Shift
Pay Through Rehire? __Y__N Date Severance Pay Approved? __Y__N
Leave of Absence: From ___________ To __________
To:
Job and Salary Change
Phone
__Replacement For:
Marital Status
Termination __Voluntary __Involuntary Start Date
Grade Level
State
Department
Employment __New Hire __Rehired Hire Date
S. S. #
From: Old Title/Salary
New Title/Salary
Comments
Approval Signatures Prepared By:
Date
Supervisor:
Date
Audited By:
Date
Personnel:
Date
Employee:
Date
Personnel:
Date
Personnel Change Notice __ Employment __ Terminate __ Change Explanation________________________________ Employee
Employee #
Address
City
Job Title
Start Date
Location
__Temporary __Part Time Age
Sex
Last Day Worked
Hire Date
Paid Days Accrued
Change __ Rate/Salary __ Job __ Location Location Change
Phone
Education
Shift
Pay Through Rehire? __Y__N Date Severance Pay Approved? __Y__N
Leave of Absence: From ___________ To __________
To:
Job and Salary Change
Phone
__Replacement For:
Marital Status
Termination __Voluntary __Involuntary Start Date
Grade Level
State
Department
Employment __New Hire __Rehired Hire Date
S. S. #
From: Old Title/Salary
New Title/Salary
Comments
Approval Signatures Prepared By:
Date
Supervisor:
Date
Audited By:
Date
Personnel:
Date
Employee:
Date
Personnel:
Date
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