Hris User Profile Entry Form
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1HRIS USER PROFILE
ENTRY FORM
AGENCY NAME: ___________________________________________________________________________________________________
FIMS NUMBER: _____________________________________________
YES NO COVERED BY THE DIVISION OF PERSONNEL?
AUTHORIZATION NUMBER: ______________________
AUTHORIZATION NAME: ___________________________________________
1.
LOGIN ID: ______________________________
Enter the User’s System (Mainframe) Logon ID – Example: xx#xxxx
2.
USER LAST NAME: ______________________________
Enter the User’s Last Name
3.
USER FIRST NAME: ______________________________
Enter the User’s First Name
4.
ADDRESS 1: ______________________________
Enter the User’s Work Mailing Address
5.
ADDRESS 2: ______________________________
Enter the User’s Work Mailing Address Second Line, if necessary
6.
CITY: ______________________________
Enter the User’s Work City
7.
STATE: ______________________________
Enter the Organization’s Work State
8.
ZIP CODE: ______________________________
Enter the User’s Work Zip Code
9.
TELEPHONE: ______________________________
Enter the User’s Work Telephone Number
10.
FAX: ______________________________
Enter the User’s Work Fax Number
11.
EMAIL: ______________________________
Enter the User’s Work Email Address
12.
CICS PRINTER ID: ______________________________
Enter the User’s CICS Printer ID (region RA)
USE THE CODES IN THE RIGHT COLUMN FOR EACH OF THE ACCESS FIELDS BELOW – USE ONLY ONE CODE FOR EACH FIELD.
ACCESS CODES:
_________ HRIS (I, U, N)
_________ TENURE (I, U, N)
_________ PIMS (Y, N)
_________ TSO LOGON (Y, N)
I = Inquire
Y = YES
_________ WV-11 APPROVAL AUTHORITY (Y, N)
_________ REPORTS (Y, N)
U = Update
N = No
NOTE: For access to the posting system, you must complete the
Job Posting Access Authorization
Form, which is also available on the
“Forms, Sample Documents,
Etc.” link.
Division of Personnel’s website under the
REQUESTED BY (TYPED OR PRINTED):
NAME: _____________________________________________ TITLE: ______________________________________________________
SIGNATURE: _____________________________________________________________
DATE: ________________________________
STOP HERE AND SEND YOUR FORM TO:
WV Division of Personnel
Employee Information/Transaction Processing
State Capitol, Building 6, Room 416
NOTE:
1900 Kanawha Boulevard, East
INTERDEPARTMENTAL MAIL
Charleston, West Virginia 25305
MAY BE USED
FOR OFFICE OF TECHNOLOGY USE ONLY:
AuthOrg _______________
WF _______________
Cv _______________
Ex _______________
TPX _______________
Connect _______________
COMPLETED BY: _________________________________________________________
DATE: ________________________________
For questions, contact Teresa Morgan: 304-558-3950 ext 57220 -or- teresa.k.morgan@wv.gov
01/29/14
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