Date post: | 12-Sep-2015 |
Category: |
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Upload: | ricardoruiz |
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Last Name: First Name:
Current Department /Cost Center Employee ID #:
Name Change Cambio de nombre
You will need to provide government documents confirming the name change
Address Change Cambio de direccion
Street Address / Direccion Apt # City / Ciudad State/Estado Zip Code / Codigo Postal
Contact Number(s) Numero Telefonico
Home / Casa
Mobile / Celular
Home / Casa
Mobile / Celular
Only complete the fields you are requesting to update/change.
PERSONAL INFORMATION (completed by employee)
Emergency Contact Contacto de Emergencia Name / Nombre Contact # / Numero Telefonico
Relationship / Relacin Parent / Padres
Sibling / Hermano(a) Child / Hijo(a)
Other / Otros
Spouse/ Domestic Partner Cnyuge / Pareja Domstica
POSITION MANAGEMENT
Employment Status:
Position Title:
Reports To/Manager:
FROM TO
Department/ Cost Center [LL5]:
Work Center [LL6]:
Only complete the fields you are requesting to update/change.
Status Change Promotion Transfer Demotion Accommodation Other:Reason for Change:
Effective Date:
Employee Action Form (EAF)Please complete electronically for
full form functionality & then print!
Total Pay Rate*:
* Total Pay Rate is Base Rate + Factors **Confirm with Payroll if employee already has Process Expert or Leader pay included in Total Pay Rate. Max rate for Team Leader is $2.50, this includes any previous leader/expert pay
COMPENSATION MANAGEMENT
Other:DemotionTransferPromotionReason for Change: Merit Increase
Per Hour
Per Year
Per Hour
Per Year
Process Expert [$0.50]** Plant Only
Team Leader [$2.50]** Plant Only
Lead Pay [$1.00] Transportation Only
Mentor Pay [$1.00] Transportation Only
Select Factors Calculated in Total Pay Rate*Select Factors Calculated in Total Pay Rate*Mentor Pay [$1.00] Transportation Only
Lead Pay [$1.00] Transportation Only
Team Leader [$2.50]** Plant Only
Process Expert [$0.50]** Plant Only
Effective Date:
Pay Grade Change: (salaried employees only)
FROM TO
Current:
Grade # - Grade Description
New:
Grade # - Grade Description
APPROVAL / CONFIRMATION
For all changes excluding personal information, two levels of approvals are needed. Forms missing approval will not be processed.
HUMAN RESOURCES / PAYROLL USE ONLY
Personal Data Change Checklist
Changed in Kronos
Notify Payroll if address change is outside of 5 Boroughs or out of State
Changed in 401k
I-9 Updated (if name change)
Processed By:
Processed Date:
Position / Salary / Labor Level Change(s) Checklist
Change Processed in Kronos
Retroactive Pay Issued?Yes
No
Processed Date:
Processed By:
Separation of Employment Checklist
PTO Paid Out? Yes No
Processed Date:
Processed By:
# of Days:
Processed in Kronos
TALX Data Entered
If Exempt EE, Payroll notified of stop payment
Personal & Medical file pulled for scanning
I-9 Relocated to Inactive Binder for Company
Severance Agreement Attached (if applicable)
SUBMIT COMPLETED FORMS TO HUMAN RESOURCES
Employee Action Form (EAF)
Print Name Signature Date Approver
Employee Signature
Current Department Manager [ Not required for Personal Information]
New Department Manager [ Required for Transfer Only ]
Senior Department Manager [ Transfer /Salary Increase Only ]
Talent Acquisition Manager [ Transfer /Salary Increase Only ]
HR Business Partner [ Required for Termination Only ]
Last day employee physically worked:
Reason for Separation:
Separation Type:
Separation Effective Date:
# of Days*
Only if: Resignation 2Wks Notice, Retirement or approved by SVP of Human Resources. Max = 10 Days / 80 HRS
Severance Agreement?Please Attach Agreement
Eligible For PTO pay out
Checklist
Company Assets Collected (if applicable):
ID Card Smart Phone / Nextel
Laptop Parking Lot Pass/Key
Desk Keys
SEPARATION OF EMPLOYMENT
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