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Fall 2010 Full-Time PAR List
Submit Personnel Action Request Forms (PAR's) to Human Resources for the following Full-Time Faculty
transactions using the effective dates indicated below. PARs should be submitted 30 days prior to the beginning of
a semester and not later than September 1st to ensure processing for the September pay period.
PARS Needed to Wrap up 2009-2010
Appointment Effective Fall
Transaction Type Academic 12 Month Comments Guide
Year Sample
Return from Leave without 08/01/2010 08/18/2010 or Indicate the Effective Date of return from #4
Pay or other actual Leave; Those who worked Fall '09 and were
08/18/2010* on leave Spring '10 must be returned on
08/01/10 to receive Full August '10 warrant
(6th warrant for Fall 2009).
Return from Difference in Pay 08/18/2010 08/18/2010 or PARs required for returns from DIP or #7
(DIP) Leave other actual irregular Sabbaticals. No PAR needed for
Returns from regular Sabbaticals; HRIS will
process returns centrally.
Retirements * Varies Varies Effective Date of Separation must be prior to #8
1st day of new AY or Semester and should be
at least one day before the PERS Retirement
Date.* Attach documentation and indicate on
the PAR whether or not the person will
participate in FERP.
Separation / Resignation * Varies Varies Attach Copy of Resignation Letter.* # 10
Completing 5 Years of FERP Varies - Attach Copy of Resignation Letter.* # 11
PARS Needed for Fall 2010 and AY 2010-2011
Appointment Effective Fall
Transaction Type Academic 12 Month Comments Guide
Year Sample
New Appointments 08/18/2010 08/18/2010 or Indicate # of yrs credit granted toward tenure; #1
(Temporary and Tenure Track) other actual visa reqs; and degree reqs on PAR. This PAR
type to be sent with Hiring Packet to Faculty Affairs.
Temporary Reappointments 08/18/2010 08/18/2010 or Indicate Duration of Appointment and #2
other actual appropriate Appt End Date.
Begin Leave without Pay 08/18/2010 08/18/2010 or Indicate the anticipated Leave End Date on #3
other actual PAR and whether a Professional or Personal
Leave. Attach copy of approved application.
Begin Sabbatical / DIP Leave 08/18/2010 08/18/2010 or No PAR needed for Returns from regular #5&
other actual Sabbaticals. HRIS will process returns #6
centrally. PARs required for returns from
DIP or irregular Sabbaticals.
FERP Appointments 8/18/2010 N/A Beginning New FERP teaching 50/50 or Fall #9
only, or continuing FERP teaching Fall only.
No PAR required for faculty continuing to
teach in FERP 50% each semester or who
teach 100% Spring only.
Reassignments 8/18/2010 Varies AY to 12 mo & 12 mo to AY, etc. Faculty
Affairs will prepare the PARs for all
incoming and outgoing Chairs.
* Separation/Clearance Forms (Parts 1 & 2) must be submitted for resignations, separations and retirements; Only Part 1 of the Separation/Clearance Forms
must be submitted for retirements participating in FERP with Part 2 to be submitted upon Final Separation.
Office of Human Resources / Academic Personnel
0c5b56bb-6880-4deb-bde5-99a93e265078.xls 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
1
1. College/Division: CHUM Date: July 21, 2010
2. Empl ID #: 009651001 Record #: 0 Empl Position #: 99754321
3. Reports to (name): Steven Jones Reports to (position #): 99798765
4. Name: X Walker A Smith
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Hiring new tenure track faculty member beginning Fall 2010. No credit toward
tenure or sabbatical. Possesses Ph.D.
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
8. New/Changed
Information
Associate Professor Academic Year English
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9. $0.00
Information
10. New/Changed 10148 2360 8/18/2010 INDEF 4 1.000 $6,178 $6,178.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
11. $0.00
Information
12. New/Changed $0.00
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form for New FT Tenure Track Faculty with complete Hiring Packet to Faculty Affairs ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #1 New Tenure Track Fall 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
2
1. College/Division: CECS Date: July 21, 2010
2. Empl ID #: 009655100 Record #: 0 Empl Position #: 99746892
3. Reports to (name): John Smith Reports to (position #): 99774123
4. Name: X Alejandra A Martinez
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Full Time Lecturer appointment for 1 year with possible renewal for 2 additional years.
(Reassignment. Do not settle out, let pay run out.)
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Lecturer, C Academic Year Computer Science
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10132 2358 5/24/2010 4 3.000 0.200 $4,755 $951.00
10. New/Changed 10132 2358 8/18/2010 5/27/2011 4 1.000 $4,900 $4,900.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
11. $0.00
Information
12. New/Changed $0.00
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #2 Temp Reappointment 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
3
1. College/Division: MDECOE Date: July 21, 2010
2. Empl ID #: 100014000 Record #: 0 Empl Position #: 99713579
3. Reports to (name): John Roberts Reports to (position #): 99727890
4. Name: X Michael W Wright
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Professional Leave without Pay for Fall 2010 (copy of approved application attached).
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Elementary Education
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10124 2360 INDEF 5 1.000 $6,787 $6,787.00
10. New/Changed 10124 2360 8/18/2010 12/22/2010 5 0.000 $6,787 $0.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
11. $0.00
Information
12. New/Changed $0.00
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #3 Begin PROF LWOP 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
4
1. College/Division: MDECOE Date: July 21, 2010
2. Empl ID #: 009655891 Record #: 0 Empl Position #: 99742411
3. Reports to (name): John Roberts Reports to (position #): 99727890
4. Name: X Joann W Allen
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Return from Professional Leave without Pay. Credit leave toward sabbatical eligibility.
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Elementary Education
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10124 2360 5/24/2010 5 0.000 $6,787 $0.00
10. New/Changed 10124 2360 8/18/2010 INDEF 5 1.000 $6,787 $6,787.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #4 Return from LWOP 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
5
1. College/Division: CSBS Date: July 21, 2010
2. Empl ID #: 100016000 Record #: 0 Empl Position #: 99756901
3. Reports to (name): Henry Jones Reports to (position #): 99745219
4. Name: X Thor A Johnson
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Sabbatical Leave for Fall 2010 semester. One semester at full salary.
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Psychology
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10176 2360 INDEF 5 1.000 $6,787 $6,787.00
10. New/Changed 10176 2360 8/18/2010 12/22/2010 5 1.000 $6,787 $6,787.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #5 Begin Sabbatical 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
6
1. College/Division: CSBS Date: July 21, 2010
2. Empl ID #: 10001700 Record #: 0 Empl Position #: 99745879
3. Reports to (name): Mary A Doe Reports to (position #): 99724685
4. Name: X Lisa K Wong
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Begin Difference in Pay Leave for 2010-2011 Academic Year.
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Sociology
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10177 2360 INDEF 5 1.000 $7,251 $7,251.00
10. New/Changed 8/18/2010 5/27/2011 5 $7,251 $3,795.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00 ..
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks: DIP Salary= Base Salary minus minimum of
Instructor, Rank 2 (currently $3,456)
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #6 Begin DIP Leave 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
7
1. College/Division: MDECOE Date: August 18, 2010
2. Empl ID #: 009655891 Record #: 0 Empl Position #: 99742411
3. Reports to (name): John Roberts Reports to (position #): 99727890
4. Name: X Byron B Ellis
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Return from Difference In Pay Leave (Spring 2010 only DIP).
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Elementary Education
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10124 2360 5/24/2010 5 1.000 $6,787 $3,331.00
10. New/Changed 10124 2360 8/18/2010 INDEF 5 1.000 $6,787 $6,787.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #7 Return from DIP Leave 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
8
1. College/Division: MCCAMC Date: July 21, 2010
2. Empl ID #: 100067890 Record #: 0 Empl Position #: 99710123
3. Reports to (name): Mary S Doe Reports to (position #): 99744556
4. Name: X Addis A Jones
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Service Retirement effective August 17, 2010, per attached documentation.
PERS Retirement date of August 18, 2010. (Will not participate in FERP)
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Assistant Professor Academic Year Art
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10094 2360 INDEF 3 1.000 $5,700 $5,700.00
10. New/Changed 10094 2360 8/18/2010 3 0.000 $0 $0.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_____ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #8 Service Retirement 07/21/2010
Faculty Personnel Action Request Form
9
1. College/Division: MCCAMC Date: July 21, 2010
2. Empl ID #: 100067890 Record #: 0 Empl Position #: 99710123
3. Reports to (name): Mary S Doe Reports to (position #): 99744556
4. Name: X Hannah A Rose
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Faculty Member commencing FERP participation, Fall 2010. Indicate the Semester when FERP Begins
Will teach 100% each Fall semester. Indicate if facutly will teach 50% each Fall and Spring or 100% either Fall or S
Based on 5 Yr FERP Program; Last Year of FERP = 2014-2015. Indicate the 5 Year time period
Service Retirement Date of 08/01/2010 Indicate the Service Retirement Date from the 1st PAR
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant X FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Associate Professor Academic Year Art
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current
9.
Information
10094 2360 4 $5,800 $0.00
Indicate if timebase = .50 for teaching 50% each Fall & Spring
10. New/Changed 10094 2360 8/18/2010 12/22/2010 4 1.000 $5,800 $5,800.00
Information If teaching Fall, the effectove date is the 1st day of the Fall semester
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary If teaching Spring, the effective date is the 1st day of the Spring semester
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #9 New 1 Semester FERP 07/21/2010
Faculty Personnel Action Request Form
9
1. College/Division: MCCAMC Date: July 21, 2010
2. Empl ID #: 100067890 Record #: 0 Empl Position #: 99710123
3. Reports to (name): Mary S Doe Reports to (position #): 99744556
4. Name: X Hannah A Rose
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Faculty Member commencing FERP participation, Fall of AY 2010-2011.
Will teach 100% each Fall semester.
Based on 5 Yr FERP Program; Last Year of FERP = 2014-2015.
Service Retirement Date of 08/01/2010
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant X FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Associate Professor Academic Year Art
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
9. Current Information 10094 2360 4 $5,800 $0.00
10. New/Changed 10094 2360 8/18/2010 12/22/2010 4 1.000 $5,800 $5,800.00
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
$0.00
11. Current Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #9 New 1 Semester FERP (2) 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
10
1. College/Division: CSBS Date: July 21, 2010
2. Empl ID #: 007121700 Record #: 0 Empl Position #: 99752108
3. Reports to (name): Mary A Doe Reports to (position #): 99724685
4. Name: X Caroline R Lynch
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Separation PAR. Faculty member resigned. (Resignation letter attached )
Last day worked: 05/24/2010.
6. Part-Time X Full-Time GA TA ISA Rehired Annuitant FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Sociology
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current 10177 2360 INDEF 5 1.000 $6,000 $6,000.00
9.
Information
8/18/2010 0.000 $0 $0.00
10. New/Changed
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #10 Separation-Resignation 07/21/2010
FACULTY PERSONNEL ACTION REQUEST FORM
11
1. College/Division: CSBS Date: July 21, 2010
2. Empl ID #: 007121800 Record #: 0 Empl Position #: 99752508
3. Reports to (name): Mary A Doe Reports to (position #): 99724685
4. Name: X Farzanah R Regina
Mr. Ms. Dr. First Name MI Last Name
5. Action Requested: Final Separation. Faculty member completed 5 Years of FERP.
Last day worked: 05/24/2010.
6. Part-Time Full-Time GA TA ISA Rehired Annuitant x FERP PRTB
Job Classification/Grade Academic Year/12-Month/Monthly Department
7. Current
Information
Professor Academic Year Sociology
8. New/Changed
Information
Transaction Appt/Leave
Job #1 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current 10177 2360 INDEF 5 0.500 $6,000 $3,000.00
9.
Information
8/18/2010 0.000 $0 $0.00
10. New/Changed
Information
Job #2 Dept ID Job Code Effective Date End Date Rank Paid Units* Time Base Base Salary Actual Salary
Current $0.00
11.
Information
$0.00
12. New/Changed
Information
13. Transitional Leave Balances: Sick_______ Vacation_______ PH_______
Lines 14 & 15 For Human Resources Use Only
14. Remarks:
15. Payroll Return Date: Anni Date: Visa Type
I: Probation Code: Final Anni Date: Visa Expiration
Probation Ending Date: Remaining SSI's: (2481) Admin. Fraction:
Sabbatical Elig. Date: PRTB End Date: Appt Duration:
A: DIP Eligibility Date: FERP End Date: PIMS Tran Code:
APPROVALS:
Name (Please Type or Print): Signature: Date: Extension: Mail Drop:
Prepared By: A. Assistant 7/21/2010 5500 8300
Dept Chair: M. Doe 7/21/2010 5500 8300
Dean/MAR: C. MAR 7/21/2010 4441 8236
HRAP/HROPS: Date To HR:
~ Submit Completed PAR Form to Human Resources by the 10th of the Month to meet Monthly Processing & Payroll Cut-Off Deadlines ~
* Complete for Part-Time Faculty and Teaching Associates Only
HR/AP: 0c5b56bb-6880-4deb-bde5-99a93e265078.xls / #11 Completion of 5 Yrs of FERP 07/21/2010
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