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CITY OF PUYALLUP PERSONNEL ACTION FORM (PAF) 1. Employee No.: Employee ID#. If you don’t have the ID# contact Human Resources to obtain. 2. Date of Hire: Original hire date (First day the employee worked for the City without a break in service). 3. Date of Current Position: Start date of their current position (this is the first date the employee worked in his/her current position within his/her current department). If the PAF is being completed to indicate a transfer, promotion or new position this date will match #24. 4. Emp. Name: Should include first name, middle initial (if applicable) and last name. 5. Dept.: Department employee is working in at time of PAF. 6. Date of Birth: ONLY provide on very first PAF when originally hired. 7. Address: Current mailing address. 8. Telephone: Current personal primary contact number, including area code. 9. Soc. Sec. No.: ONLY provide on very first PAF when originally hired. 10. City: City of residence. 11. State: State of residence. 12. Zip: Zip code of residence. 13. New Employee: Check only upon original hire. 14. Status: Select one box, that matches the box checked on the original authorization to fill. 15. Hours per Week: List the part-time hours per week, if applicable to position. 16. Check the box associated with the reason for the PAF. 17. Position Title Present: The title the employee had prior to this PAF being processed. If the employee is a new hire leave this column blank. 18. FLSA Status Present: Check applicable box for present position (FLSA Exempt or FLSA Non-Exempt). 19. Effective Date Present: List the date the employee started in the position held prior to the new PAF. 20. Pay Step Present: List the appropriate pay step per the salary schedule for the position the employee held prior to the new PAF. 21. Pay Rate Present: List the appropriate pay rate per the salary schedule for the position the employee held prior to the new PAF (this would be the present rate rather than the new rate). 22. Position Title New: The title the employee will have when this PAF is processed. 23. FLSA Status Present: Check applicable box for new position (FLSA Exempt or FLSA Non-Exempt). 24. Effective Date New: List the date of the employee will start in the new position. 25. Pay Step New: List the appropriate pay step per the salary schedule for the position the employee is being granted (new rate given when accepting a new assignment or receiving a step increase). 26. Pay Rate New: List the appropriate pay rate per the salary schedule for the position the employee is being granted. 27. or Hourly: Check associated box. This should align with the pay rate listed in 21 and/or 26. 28. Termination date: Complete when an employee has been assigned to a temporary or seasonal position or has resigned. 29. Budget Code: List the appropriate 10 digit budget org key followed by 511011 for the object code. 30. – 34. Complete when submitting a PAF for reason of demotion, reprimand/suspension, or separation (includes resignation and retirement). Effective date is the last day worked. 35. – 37. Complete this section only when an employee is taking a leave of absence. 38. Bargaining Unit: Check one box only. 39. Fringe Benefits: Check one box only. 40. Explanation: Provide a simple explanation of why the PAF is being submitted for processing. This section should not be left blank. 41. Supervisor: The position supervisor should sign the PAF in ink. 42. Date: The position supervisor should date the PAF and forward to department head. 43. Department Head: The department head should sign the PAF in ink. 44. Date: The department head should date the PAF and then forward to Human Resources for completion of routing.