UMD Academic Personnel Action Form
Ready for "Prepare to Hire" Job Opening#: _____________
Faculty, P&A New Hire-Benefits Packet
CS to P&A Change
Is this a No Search Hire?
Yes
No If yes, what type? ________________________________
PERSONAL DATA
Name:________________________________________________
Empl ID #: ______________
Empl Rcd #: _____
(Required on all but new hires)
Last, First, Middle
(legal name as appears on Social Security card)
ACTION/REASON
Effective Date
Action
Reason
1. _______________
___________________
_____________________________________
_____________________________________
2. _______________
___________________
3. _______________
___________________
_____________________________________
HR&EO to Enter Absence Event:
Excused Paid
Excused Unpaid Details:
Leave of Absence
Other
For Partial Days, # Hrs with Pay: ______ # Hrs without Pay: ______
Begin Date: __________
End Date: __________
JOB DATA
Job Indicator:
Pri Job
Expected Job End Date: ___________
Work Location
Sec Job
Position #:______________
Dept ID:_________
Expected Return Date: ___________
Job Information
Empl Class:
_______________________________________
(use drop down)
Faculty only:
Job Code: _________
Standard hours: _______
Percent Time: _______
Semester Type:
8.9 Appt Type: ____
8.9 Appt Term: ____
Fall
Spring Faculty Union Code:
I1/JDN Not eligible
UEA Conversion:
I2/JDE UEA eligible
Contact Hours: _______
Conversion FTE: _______
Eligible for vac:
Yes =
UMACADEMIC
Pay Group:
Payroll
Employee Type:
____
_________________
(Absence Eligibility Group)
No
Compensation:
Components of Pay:
Compensation Frequency:
(completion required)
Comp Rate Freq.
Rate Code
Comp Rate
H
B
1.
Annual
Hourly
Biweekly: ____________
__________
______________________
B10
B09
2.
Annual
Hourly
__________
______________________
ABBR: _____________
(Required for faculty, P&A, post docs)
3.
Hourly
Annual
__________
______________________
Contract Pay
______________
Contract Pay Type:
Renew automatically:
No
Yes If yes, number of Renewals: ____
Contract Begin: __________
Payment Begin: __________
Termination Date: __________
Actual Start Date: __________
Contract End: __________
Payment End: __________
Tenure Data
Status:
Home Rank: _______
Tenure Home: _______
_________________
(Z Dept ID)
Track Start Date: __________
Change Date: __________
Change Reason: _________________________________
(eff date)
(i.e. Hire, Promotion, Granted, Resignation, etc)
Additional Pay Panel
If needed, Job Data Override Details
Earnings
Dept
Job Code
Eff Date
End Date
Hours
Hourly Rate
Position#
Earn Code
1.
2.
3.
If needed, Combo Code Override:
General Comments
:
(please remember to "show your work")
HR&EO Use Only:
Prepared By:
Date:
Phone#:
HRMS Entry:
Authorized By:
Date:
HRMS Check:
Form Last Updated 4/20/16