Homepage Blank Employee Status Change Form
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The Employee Status Change form is an essential document for any organization that needs to track changes in an employee's status. This form is used to document various transitions, such as promotions, demotions, transfers, or changes in employment status, like moving from part-time to full-time. Accurate completion of this form ensures that all relevant departments, including HR and payroll, are updated promptly, which helps maintain accurate employee records. The form typically requires details such as the employee's name, position, and the specific change being made, along with the effective date of the change. Additionally, it may require signatures from supervisors or HR personnel to confirm that the changes have been reviewed and approved. By utilizing this form, companies can streamline their internal processes, minimize confusion, and ensure compliance with employment regulations.

Dos and Don'ts

When filling out the Employee Status Change form, it is important to keep certain guidelines in mind. Here is a list of things you should and shouldn't do:

  • Do read the entire form carefully before starting.
  • Do provide accurate and up-to-date information.
  • Do check for any required signatures.
  • Do keep a copy of the completed form for your records.
  • Do submit the form to the correct department.
  • Don't rush through the form.
  • Don't leave any mandatory fields blank.
  • Don't use abbreviations unless specified.
  • Don't forget to update your contact information if it has changed.
  • Don't submit the form without reviewing it for errors.

Employee Status Change Sample

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:_______________________

Listed Questions and Answers

  1. What is the Employee Status Change form?

    The Employee Status Change form is a document used to officially record changes in an employee's status within an organization. This can include changes such as promotions, demotions, transfers, or terminations. It ensures that all relevant departments are informed and can update their records accordingly.

  2. Who needs to fill out the form?

    The form typically needs to be filled out by a supervisor or manager who is overseeing the employee whose status is changing. In some cases, HR may assist in completing the form to ensure all necessary information is captured accurately.

  3. When should the form be submitted?

    The form should be submitted as soon as the decision regarding the employee's status change has been finalized. Prompt submission helps to ensure that payroll and other administrative processes are updated without delay.

  4. What information is required on the form?

    Typically, the form requires the following information:

    • Employee's name and ID number
    • Current job title and department
    • New job title and department (if applicable)
    • Effective date of the change
    • Reason for the change
    • Signatures of the supervisor and HR representative
  5. How does the status change affect benefits?

    Changes in employment status can affect benefits eligibility. For example, a promotion may lead to a higher salary and different benefits, while a termination may result in loss of benefits. Employees should consult with HR to understand how their specific changes will impact their benefits.

  6. Is there a deadline for submitting the form?

    While there may not be a strict deadline, it is best to submit the form as soon as possible after the decision has been made. Delays can lead to complications with payroll and other administrative tasks.

  7. What happens after the form is submitted?

    Once the form is submitted, HR will review the information and make the necessary updates to the employee's records. Notifications may be sent to relevant departments to ensure everyone is informed of the change.

  8. Can the form be used for multiple employees?

    No, the Employee Status Change form is typically designed for one employee at a time. If there are multiple changes, separate forms should be completed for each employee to maintain clarity and organization.

  9. What if I make a mistake on the form?

    If a mistake is made, it is important to correct it immediately. You can either cross out the error and write the correct information or submit a new form with the accurate details. Always ensure that the corrections are clear to avoid confusion.

  10. Who can I contact for help with the form?

    If you have questions or need assistance, you can reach out to your HR department. They are equipped to provide guidance and answer any specific questions you may have about the form or the status change process.

Form Overview

Fact Name Description
Purpose The Employee Status Change form is used to document any changes in an employee's job status, such as promotions, transfers, or terminations.
Who Uses It This form is typically used by human resources departments, managers, and employees to ensure proper record-keeping of employment changes.
Legal Requirement In many states, maintaining accurate employee records is mandated by labor laws, which can include regulations from the Fair Labor Standards Act (FLSA).
State-Specific Forms Some states may have specific forms or additional requirements. For example, California requires compliance with the California Labor Code regarding employee records.
Submission Process Typically, the completed form must be submitted to the HR department for processing, and it may also need to be signed by the employee and their supervisor.
Retention Period Employers are generally advised to retain these forms for a minimum of three years, in line with federal and state employment laws.