HR - Change of Staff Employment Info

Complete this form to change the title, pay and/or status of a current employee.

1Employee Information > 2Compensation Information > 3Title Change Information > 4Employment Status > 5Review Your Entry
Employee Information
Employee Name Employee Name First Last
Employee ID#
Must be 7 characters. Currently Entered: 0 characters.
Department
Reason for the Change

Reason for the Change Additional Position Changed Assignment Correction Demotion End Position Promotion Transfer Change in Pay
Effective Date of Change Effective Date of Change / MM / DD YYYY

Changes may only be made at the start of a pay period. Please allow 5 business days for processing.
What changes will be made for this employee?

What changes will be made for this employee? Compensation Title Status (i.e. RFT, LPT, RPT. Temp)

Please mark all that apply. Your answers will determine which sections of the form you will be asked to complete.
Submitter Email Address:

This is for you to receive a copy of the completed form.
New Direct Supervisor Email (or current if no change)
Save my progress and resume later
Enter Your Email Address *

A special link to resume the form will be sent to your email address.