LEE COUNTY - REQUEST FOR CHANGE IN PERSONNEL STATUS
Employee Name:
Employee Number:
Effective Date:
CHANGE FROM:
Job Title: Salary Grade: Department Code: Job Code:
Part-Time Temporary
FLSA Exempt?
Full-Time Seasonal
Work Hours:
Current Salary:
40
Job Slot:
Other ________
Per
Location:
Yes
No
CHANGE TO:
Job Title: Salary Grade: Department Code: Job Code:
Part-Time Temporary
FLSA Exempt?
Full-Time Seasonal
Work Hours:
Requested Salary:
40
Job Slot:
Other _________
Per Location:
Yes
No
Personnel status changes will be implemented only at the beginning of the next pay period after approval by the County Administrator and filed with the Payroll Department. REASON FOR CHANGE New Hire Discharge Remarks:
Promotion
Merit Salary Increase
Resignation
General Salary Increase
Transfer Other
Demotion
APPROVAL:
1st Line Supervisor: Date: Dept. Head: Date:
Division Manager:
Date:
County Administrator:
Date:
For Human Resource Use Only:
Human Resources: Date: