Human Resource Services PA Form
Personnel Action Form Off-Cycle Requested Revised
Revised November, 2007
Page 1 of 1
Cash Iwanna S
Last Name First Name Middle Name
Building Code (office location): CIVL West Lafayette Calumet Fort Wayne North Central
Person ID: 12345678
SSN DOB Gender
For Separations and End Add'l
Separation 01 - 01 - 08
Appts, this is the first day in
Personnel # 12345678
Action Effective Date withdrawn status.
Transfer Reason Change in Pay Reason Separation Reason Position Reclassification Reason
Position # 10451 West Lafayette Faculty Tenured/Tenure Track 9 Month AY Exempt
Personnel Area Employee Group Employee Subgroup
Professor of Chemisty 131 - Chemistry Pay w/o benefits
Position Title Org. Unit # and Name Personnel Subarea
- - - - - - - - - - - - - - - - - - THE FIELDS LISTED BELOW DO NOT NEED TO BE COMPLETED FOR SEPARATIONS OR END ADDITIONAL APPOINTMENTS - - - - - - - - - - - - - - - - - - - - - - - - -
Contract, if applicable Time Admin Payroll Admin Work Schedule
Purdue Standard: Monday - Sunday
Pay Scale Level
Work Week Shift Code
Salary/Period Rate Hourly Rate Capacity Utilization Level (FTE)
Annual Rate Full Time Annual Rate Admin Suppl.
Business Office Contact (name & phone #): Jane Doe 40000
Check if attached: Form 13 I-9 WH4 W4 Offer Letter (if applicable) Contract (if applicable)
Appointments true separation date is 12/31/07, but so the pay doesn't prorate for December us 01/01/08 as action date.
Approval Signatures APPROVED
Dept Head Date: Purdue University
Business Office Date:
HR Svcs Date:
For the President
Please send completed form to Shared Service Center/FREH. Human Resource Services PA Form
Instructions for Personnel Action (PA) Form
(The Personnel Actions (PA) form is to be completed by an individual who is responsible for processing payroll documents.)
Use the PA form for the following actions:
• New Hire : This represents an employee who is new to the University (not in the system).
• Rehire: This represents an employee who has left the University and then returns (employment status is "withdrawn" in the system).
• Transfer : This represents an employee moving from one position to another position, either in the same org. unit or a different org. unit.
• Change in Pay : This represents a change in an employee's pay PAY, CUL, EMPLOYEE SUBGROUP, or REAPPOINTMENT ACTION.
(employee is staying in the same position and org. unit)
• Additional Appointment : This represents an employee who already holds an appointment at the University and is adding
an additional position. This is also called a split or concurrent appointment.
• End Additional Appointment : This represents an employee who holds multiple appointments and at least one is ending.
• Separation : This represents an employee who is terminating employment at the University.
• Position Reclassification : This represents a change to a position which effects the employee in the position; POSITION TITLE,
EMPLOYEE GROUP or EMPLOYEE SUBGROUP.
HOW TO COMPLETE THE PA FORM:
• Revised: Check this box for a revised PA form
• Page of Pages: if multiple forms are needed for one person, indicate the number of pages
• Name: use the employees legal name (sources could be birth certificate, social security card, visa, passport etc.)
• Building Code for office location: Enter the building code for the individuals office location. Click on the hyperlink and then
scroll through the "Locate Building by Name" to find the building code.
• Social Security Number : New Hires only; record the employee's SSN. This has to be hand written due to security.
• Date of Birth : New Hires only; record the employee's DOB.
• Gender: New Hires only; record the employee's gender
• Person ID : complete this field for all actions except for New Hire (you will not have Person ID for a New Hire, this is
assigned by the system when the employee's information is keyed into the system)
• Note: to find the Person ID use t-code PA20 and search for the employee in the Personnel No. field, once you have the employee's data,
go to "assignment details" to find their Person ID. Also see B@P processes for more detailed instructions on using PA20.
• Action : from the drop down box select the appropriate action base on the definitions listed above
• Effective Date: the date the action begins. For Separation or End Additional Appointment Actions, this is the day AFTER
the last day of work
• Personnel #: this is also known as the PERNR (you will not have a Personnel # for a New Hire or Add Additional Appointment, this is
assigned by the system when the employee's information is keyed into the system) Note: to find the Personnel # use t-code PA20 and
search for the employee in the Personnel No. field, once you have the employee's data, go to "assignment details" to find their Personnel #.
• Transfer Reason: if the Action selected is "transfer", use the drop down box to select the transfer reason that best fits the situation
• Separation Reason: if the "separation" action is selected, use the drop down box to select the appropriate separation reason that best fits
• Change in Pay Reason: if the "change in pay" action is selected, use the drop down box to select change in pay reason that best fits
• Position #: this is the position # that is being affected by this action Note: to find the Position # use t-code PA20 and search for the
employee in the Personnel No. field, once you have the employee's data, go to "assignment details" to find their Position #, t-code
PPOSE is also an option, you can be used to search on an Org. Unit.
• Personnel Area: select the appropriate campus location from the drop down box
• Employee Group: select the appropriate employee group from drop down box (see url to a crosswalk below)
Position Code to Job & Enterprise Structure Crosswalk
• Employee Subgroup: select the appropriate employee subgroup from the drop down box (see url to a crosswalk below)
Position Code to Job & Enterprise Structure Crosswalk
• Position Title: (max. 40 spaces) this is the title of this position, for 1-1 positions this can be an unique title, for grouped positions this
is a standard title and can not be changed. Use PPOSE to identify the the position and the title
• Organization Unit # and Name : this is the HR organization unit # (url listed below) and the Org. Unit Name (max. 40 spaces)
HR Org. Unit Crosswalk
• Personnel Subarea: select the appropriate personnel subarea from the drop down box (see url to a crosswalk below)
Position Code to Job & Enterprise Structure Crosswalk
Contract through Administrative Supplement fields do NOT need to be completed for Separation & End Additional Appointment Actions
• Contract: select the appropriate contract if applicable from the drop down box
• Time Admin: this code represents a person or a group of people who would be entering time worked for non-exempt and vacation, sick
leave etc. for exempt employees
Payroll Admin Codes
• Payroll Admin: is also know as the delivery code (where the employee's check will be delivered), the url listed below has a complete
list of Payroll Admin. Codes. If an employee has multiple appointments, they can only have one Payroll Admin Code
• Work Schedule: select the appropriate work schedule, all grad students should be EXSTAND all undergrads should be BWSTAND
• Work Week: select the appropriate work week from the drop down box; most employees should have the Purdue Standard
• Shift Code: in SAP the field is titled Add'l Time ID, select from the drop down box, most employees will have the Day shift
• Pay Scale Level: for non-exempt regular and temporary: the pay scale level is in the title and on the position classification notice from HR
A/P, faculty, lecturer, post doc, intern, graduate students and residents DO NOT need a pay scale level
• Salary/Period Rate: Annual rate / term of appointment, use for exempt employees; use Hourly rate for non-exempt employees.
Do NOT include Administrative Supplements in the Salary/Period Rate.
• Hourly Rate: for non-exempt employees only; use Salary/Period rate for exempt employees
• Capacity Utilization Level: also known as FTE, (i.e. 100% = 100.00, 50% = 50.00), non-exempt students always = 0.01
• Annual $ Rate: Period rate multiplied by Employee Subgroup (term of appointment). Do NOT include Administrative Supplements
in the Annual Rate. Needed for all staff types.
• Full Time Annual Rate: Period rate / Capacity Utilization Level (FTE). Do NOT include Administrative Supplements in the
Full Time Annual Rate.
• Administrative Supplement: If applicable, indicate Period Rate (not total amont) for administrative supplement. This amount should NOT
be included in the "Salary/Period Rate", "Annual $ Rate", or "Full Time Annual Rate" fields.
Business Office Contact: identify business office contact name and phone number. This will be the individual the Shared Service Center will
contact with questions regarding this form
Comments: note in the comments section any information that will be beneficial to anyone signing/reviewing/auditing the form; i.e. for a transfer,
list the position number the employees is leaving
To see the complete process go to B@P then go to "People"
SELECT GENDER SELECT EMPLOYEE GROUP SELECT PERSONNEL AREA
Male Faculty Tenured/Tenure Track Calumet
Female Visiting Faculty/Emeritus Faculty Fort Wayne
Clinical, Research, Non-Tenure <50% IUPUI
SELECTION ACTION Continuing Lecturer North Central
Limited Term Lecturer West Lafayette
New Hire Post Doc/Interns/Resident
Transfer Administrative Professional
Change in Pay Operations Assistant
Add Additional Appointment Non Exempt Professional
End Additional Appointment Clerical
Position Reclassification Temporary A/P
SELECT TRANSFER REASON Graduate Student
Resident Hall Counselor
Non Paid to Temporary Summer Operations Assistant
Non Paid to Regular Fire/Police Admin
Temporary to Regular Fire/Police BW Salary
Regular to Temporary Fire/Police Management
Emp Group Change Same Dept Police Hourly
Emp Group Change Diff Dept Non Pay
Org Unit Change Promotion
Org Unit Change Demotion SELECT EMPLOYEE SUBGROUP
Org Unit Change Lateral
Same Org Unit Promotion 9 Month AY Exempt
Same Org Unit Demotion 9 Month FY Exempt
Same Org Unit Lateral 9 Month Non Exempt
10 Month FY Exempt
SELECT SEPARATION REASON 10 Month Non Exempt
11 Month FY Exempt
Temporary or Seasonal 11 Month Non Exempt
Reduction in Force 12 Month FY Exempt
Contract not Renewed 12 Month Non Exempt
Tenure Denied Non Pay
Work Authorization Expired SELECT PERSONNEL SUBAREA
High Wages or Benefits
Career Opportunity Pay w/ benefits
Dissatisfied with Employment Pay w/o benefits
Health Reasons Non pay w/ benefits
Relocated Non pay w/o benefits
Resigned in lieu of Termination
Personal Reasons SELECT CONTRACT IF APPLICABLE
Personal Retirement Official Retiree
Inadequate Performance Retiree Spouse
Inappropriate Behavior Staff Retiree
Attendance Surviving Spouse/Dependent
Job Abandonment Disability
SELECT CHANGE IN PAY REASON 1FAA
Market Adjustment SELECT WORK WEEK
Decrease Base Pay Purdue Standard: Monday - Sunday
Change in Cap. Util Level (FTE) Police Dispatcher: Saturday - Friday
Change in Employee Subgroup Bus Driver: Wednesday - Tuesday
Budget New Year ITAP-Rec Sports: Thursday - Wednesday
Reappointment Action Animal Sci Res: Sunday - Saturday
SELECT POSITION RECLASSIFICATION REASON
SELECT SHIFT CODE
Higher Level Day
Lower Level Evening
Employee Group Change Night
Employee Subgroup Change Union Club Desk - Day
Org Unit Relationship Change Union Club Desk - Evening
Union Club Desk - Night
First Responder - Day
First Responder - Evening
First Responder - Night