Fillable Printable Blank Employee Status Change Form
Fillable Printable Blank Employee Status Change Form
Blank Employee Status Change Form
Please return this form to Human Resources
EMPLOYEE STATUS CHANGE FORM
Location: Department:
EMPLOYEE PROFILE
Employee Name: Employee #:
Date: Date Effective:
EMPLOYMENT CHANGES
New Hire: Job Title: Department:
Rehire: Job Title: Department:
Temporary: Start Date: End Date: Department:
CLASSIFICATION CHANGES
Change (Circle One)
Old Information New Information
Title/Dept: Title/Dept:
Title/Dept: Title/Dept:
Title/Dept: Title/Dept:
Title/Dept: Title/Dept:
Shift: Shift:
Location: Location:
Salary: Salary:
Status: Status:
Status: Status:
Transfer:
Promotion:
Demotion:
Title:
Shift:
Location/Dept:
Salary:
Status:
Allocations:
Commission/Bonus:
Draw/Guarantee:
Other changes:
ADDITIONAL COMPENSATION/BENEFITS INFORMATION
Please List Any Additional Changes in Compensation or Benefits:
V
ERIFICATION OF
C
HANGES
Approved By:
Date
HR Approval:
Signature Date
Employee Acknowledgement:
Signature
Date
President’s Approval
Signature Date
Date
Manager Signature
Printed Name
2nd Mgr Signature
Printed Name
Any raise in excess of 5% require a president’s signature.
VELOCITY
VEHICLE GROUP
All raises and allocation changes require signatures from all departments affected by this change. Please use the 2nd signature section to obtain this approval.
All changes that affect other department/companies that are not properly approved will not be processed.
Status:
Status:
Status:
Status:
Accounting Approval (Only for Comm./Draw/Guar.):
Signature Date
