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Free Employee Status Change PDF Form

The Employee Status Change form is a vital document used to officially record changes in an employee's status within an organization. This form may address various transitions, such as promotions, transfers, or terminations, ensuring that all relevant information is updated accurately. To facilitate these important updates, please fill out the form by clicking the button below.

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Preview - Employee Status Change Form

Employee Status Change Form

Employee Name: ___________________________________________________ Social Security #: __________________________________

Address: ______________________________________________________________________________________________________________

DT #: ___________ Location Name: _________________________________ Position: ____________________________________________

Effective Date: ______/______/______		Date of Birth: ______/______/______ E-mail: ________________________________________

Employee Status
Type of Change:	New Hire		Rehire	Employee Status Change
Regular Full Time	(30 hours or more)		Hours per week: _________
Regular Part Time	(29 hours or less)		Hours per week: _________
Temporary	(Less than 6 months)		Hours per week: _________
On Call	(As Needed)

Salary Establishment/Change
Type of Change:		New Hire		Merit Increase		Promotion		Cost of Living		Other _______________________
New Pay Rate:	$__________________			per hour		Bi-weekly salary amount			Annual Salary $______________________
				(Non-Exempt)		(Exempt)			(If Exempt)
IF SCHOOL EMPLOYEE: ( If contracted teacher, please attach a copy of the contract)
# of Pays: _____________		First Check Date: ______/______/______						Final Check Date: ______/______/______


Status Change
Location Change (Transfer)				From_______________________________ To ________________________________
Position Change				From_______________________________ To ________________________________
Leave of Absence				From_______________________________ To ________________________________
Other				_______________________________________________________________________

Termination of Employment
Last Working Day: ______/______/______
Eligible for rehire?	Yes	No (if no, list reason) _______________________________________________________________
Select ONE reason for separation:
Voluntary:
Dissatisfied w/ job or company			Retirement		School		No Call/No Show			Better job/pay/benefits/hours
Medical-self or family			Relocating		Family issues		Other________________________________________________
Involuntary:
Poor performance				Gross Misconduct			Contract Ended			Unqualified for job
Violation of company policy/procedure				Unprofessional conduct			Other________________________________________________

Remarks:______________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Parish/School/Agency Signature:______________________________________________________________ Date:_______________________

⇓ Employee Status Change PDF

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Similar forms

Employee Information Form: This document collects essential details about an employee, such as their name, contact information, and position. Both forms are used to update or confirm employee data within the company.
New Hire Form: Similar to the Employee Status Change form, this document is completed when an employee joins the organization. It captures vital information for payroll and benefits, ensuring a smooth onboarding process.
Termination Form: This form is used when an employee leaves the company. Like the Employee Status Change form, it documents important details regarding the employee's departure, including the last working day and reason for leaving.
Leave of Absence Request: When an employee requests time off, this form is essential. It records the duration and reason for the absence, similar to how the Employee Status Change form tracks changes in employment status.
Promotion or Transfer Request: This document is used when an employee is promoted or transferred to a different department. It serves a similar purpose to the Employee Status Change form by documenting changes in job title or responsibilities.
Performance Review Form: Conducting performance reviews often leads to changes in employee status, such as promotions or raises. This form captures feedback and assessments, paralleling the Employee Status Change form in documenting employment changes.
Mobile Home Bill of Sale Form: This document is essential for recording the sale or purchase of a mobile home, much like the Employee Status Change form captures important changes; for further details, refer to Auto Bill of Sale Forms.
Benefits Enrollment Form: When employees experience a change in status, they may need to update their benefits. This form collects information about their selections, similar to how the Employee Status Change form updates employment-related details.