ࡱ> \^[3 jbjbjKK 1L)w)wb Rl 8 ` D%v >>>>r(f2%4%4%4%4%4%4%$q( *bX%]NrrNNX%>>>4%>>>N>>2%>N2%>>r#T$> +vc ^d6$$t%0%D$z+|+$> ROCKLAND COUNTY EMPLOYEE JOB DATA CHANGE FORM Job, Pay, Status Changes Payroll #  FORMTEXT       From  FORMTEXT       to  FORMTEXT       SUBMITTING AGENCY:  FORMTEXT       EFFECTIVE DATE:  FORMTEXT       END DATE (If applicable)  FORMTEXT       EMPLOYEE NAME: Last:  FORMTEXT       First:  FORMTEXT       MI:  FORMTEXT     EMPLID:  FORMTEXT       BENEFITS SERVICE DATE:  FORMTEXT       ACTION CODE:  FORMTEXT       REASON CODE:  FORMTEXT       EMPL RECORD NUMBER:  FORMTEXT       TYPE OF ACTION Action Code is indicated for each action below. JOB CHANGE:  FORMCHECKBOX Civil Service Transfer in Title (DTA) (within County)  FORMCHECKBOX Change Encumbered Position (DTA)  FORMCHECKBOX Return to Former Status (DTA)  FORMCHECKBOX Reassignment (DTA)  FORMCHECKBOX Promotion (PRO)  FORMCHECKBOX Demotion (DEM) STATUS:  FORMCHECKBOX Civil Service Status Change (DTA)*  FORMCHECKBOX Reappointment in Current Status  FORMCHECKBOX Temporary (9992 or other) (DTA)  FORMCHECKBOX Second Provisional with no break in service (DTA)  FORMCHECKBOX Recertify (DTA) SALARY CHANGE: (All Actions = PAY)  FORMCHECKBOX Increment:  FORMCHECKBOX  Annual  FORMCHECKBOX  Longevity  FORMCHECKBOX Temporary Allowance/Out of Title Pay: Type:  FORMTEXT        FORMCHECKBOX Other OTHER:  FORMCHECKBOX Change Hours (DTA) *  FORMCHECKBOX Change Primary Job (DTA)  FORMCHECKBOX Probation Action (PRB)  FORMCHECKBOX Changes to Position Data (POS) *Review Retirement System Membership with employee CURRENT INFORMATION POSITION INFORMATION: TITLE:  FORMTEXT       POSITION CONTROL NUMBER:  FORMTEXT       TITLE CODE:  FORMTEXT       AGENCY INFORMATION: AGENCY:  FORMTEXT       DEPT:  FORMTEXT       PAY LOCATION:  FORMTEXT       LABOR UNIT:  FORMTEXT       SALARY INFORMATION: GRADE/BAND:  FORMTEXT       STEP:  FORMTEXT       HOURLY RATE:  FORMTEXT       SCHEDULED HOURS PER BIWEEKLY PAY:  FORMTEXT      NEW INFORMATION POSITION INFORMATION: TITLE:  FORMTEXT       POSITION CONTROL NUMBER:  FORMTEXT       TITLE CODE:  FORMTEXT       AGENCY INFORMATION: AGENCY:  FORMTEXT       DEPT:  FORMTEXT       PAY LOCATION:  FORMTEXT       LABOR UNIT:  FORMTEXT       SALARY INFORMATION: GRADE/BAND:  FORMTEXT       STEP:  FORMTEXT       HOURLY RATE:  FORMTEXT       SCHEDULED HOURS PER BIWEEKLY PAY:  FORMTEXT           Signature of Appointing Authority Date Telephone Extension ^ "$&0246Z`bvíҔ~ҔhҔ`]TP>*CJj>*CJUCJCJOJQJ\+j>*B*CJOJQJUaJph+jv>*B*CJOJQJUaJph0j>*B*CJOJQJUaJmHnHphu+j>*B*CJOJQJUaJph>*B*CJOJQJaJph%j>*B*CJOJQJUaJphB*CJOJQJaJphCJOJQJaJOJQJ^46xp$If^p`d$$Ifl:r: t0644 la$If ^` hvxz ЃqcNq6q.j>*CJOJQJU\^JaJmHnHu)jh>*CJOJQJU\^JaJ>*CJOJQJ\^JaJ#j>*CJOJQJU\^JaJOJQJ\^J*j>*CJOJQJU\^JmHnHu%j>*CJOJQJU\^J>*CJOJQJ\^Jj>*CJOJQJU\^JCJOJQJ\^JCJj>*CJUmHnHuj>*CJUjb>*CJU(*,68<@DFZ\^df Ͽ׭ϝ׭ύ׭}׭m׭j>*CJOJQJUj>*CJOJQJUj>*CJOJQJUjv>*CJOJQJU#j>*CJOJQJUmHnHuj>*CJOJQJU>*CJOJQJj>*CJOJQJU56CJOJQJ CJOJQJCJOJQJ\^J* .0DFHRTxzΓ~Γr`R=`)jj>*CJOJQJU\^JaJ>*CJOJQJ\^JaJ#j>*CJOJQJU\^JaJCJOJQJ\^JaJ)j5>*CJOJQJU^JaJ.j5>*CJOJQJU^JaJmHnHu)j5>*CJOJQJU^JaJ5>*CJOJQJ^JaJ#j5>*CJOJQJU^JaJ5CJOJQJ^JaJ CJOJQJj>*CJOJQJU$o$$Ifl:r:  t 0644 la$Ifd$$Ifl:r: t0644 la z |     + , - 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