Personnel Action Form template - PDF by JohnKirkpatrick


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                                                   PERSONNEL ACTION FORM
                                                                              Department:                                           Date:
               TEACHERS COLLEGE                                               Project/Center:
             COLUMBIA UNIVERSITY                                              Dept./Center Box #:                                   Ext:

Name:                                                                                                                         TCID:

Title:                                                                                                             Pay Grade:                   Pay Step:

From Date:                                                  To Date:                                               Term:

Salary Information:                                         Appointment Type: indicate code #                      Course Number / Section Number:
   Choose one:                                                        Appt. type code:
           Part Time                 Full Time                Appt. revision code(s):                                                      /
   Indicate one:                                            Docket Information (if applicable):                                            /
      % Full Time Base:                          OR                 Docket Date:                                                            /
Hours worked per week:                                         Highest Degree:                                                              /
   Fill in at least one:                                             Salary Allocation:

              Weekly Salary:                                                 Index                 Account                    %                      Subtotal
            Monthly Salary:
           FT Annual Base:
  Salary for Appt. Period
         One Time Payment:
    Special permission required for One Time Payments


                                                                                                          TOTAL                         %       Yellow cell amounts
Attach supporting documentation as appropriate                                                                        Should be 100.00%             should agree
Requested by:                                                        Date:      Recommended by:                                                        Date:

 (Dept. Administrator / Principal Investigator / Center Director)                                (Department Chair / Department Head)
Controller’s Office Use Only:
New Position #                                              Suffix                   Gross Salary per Pay Period $
Old Position #                                              Suffix                   Title Code (Job Loc.):   ___________   Type Code (Longevity): ________
                                                                                     For Payroll Office Use Only
Retro Period                                        Retro Pay $                                                       Next Pay Date: __________________

Approved by:                                               Date:                     Entered by: ______________________                 Date: _____________
For Personnel Office Use Only:                                                       For Dean’s / VP Finance and Administration’s Office Use Only:
Probation ending date:
                                                                                     Approved by: ___________________________ Date: _______
Approved by: ________________________ Date:_________

           Color Code: Department: goldenrod — Personnel: pink — Controller’s Office: canary — Payroll: white                                         7/01

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