UITS Human Resources/Finance Office Personnel Change Request FormDownload Word version

Division:__________________Director/Manager:_________________________________________

Personnel Action Requested
For the following reason: (Please circle/check one)

Transfer___ Reclassification___ Promotion___ New Hire___ Other___

To the following person:

Name:_______________________________________________________

Home Address:________________________________________________
Please list their home address if candidate is not currently a UITS staff member

Indicate whether they are current IU staff and whether they are appointed or hourly.
Current IU Staff(Y/N):_____
If yes above, are they Appointed(PA or Support Staff) or Hourly (receive no benefits) (A/H):____

For the following position:

Position Title:__________________________________________________________

Is this initially a 2-year (or other term limited) position (Y/N): ____

If 'Yes' but other than 2-year please indicate term: ____

Position Rank:______________

Position Number:____________
If there were other UITS staff members in the pool of applicants and an external or hourly candidate is selected over one of our currently appointed staff members, please send documentation stating why the current staff member(s) was/were not chosen.

With the following recommended salary:

Recommended salary for the new incumbent:_______________
Please give annual salary for monthly paid staff and an hourly rate for biweekly paid staff

Maximum salary previously approved for this position: ___________
Account/Sub Account for this position:_________________
If salary amount is more than previously approved by the finance office please document where the additional funding is to come from.

With the proposed start date of:_____________________
Start date is to be confirmed when oral offer is extended or accepted. Offer is not final until proper paperwork is signed. Employees new to the university must submit documents for I9 requirements before or the morning of the first day of work.

Please send a copy of the successful candidate's resume to Toni Usrey for IUB, or to Panos Niarchos for IUPUI

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Last Revised 12th March 2004
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