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Employee Change Form Shaded fields are for HR-use only. Please submit your completed form online at http://hrsc.weill.cornell.edu . If organization change involves more than one reporting change, see page 2 Employee ID Number Comments: FTE New Position Title Work Phone Employee Name (Last, First, Initial) Bldg Employee CWID Floor Room Box # Emp. Group Current Position # Current Org. Unit Name / # Cur. Grade Exempt Non-Exempt Fac/Acad Student Temp Choose Current Status: Current Annual Salary Current Non-Exempt Hourly Rate Current Temp Hourly Rate New Position # Emp. Subgroup New Org. Unit Name / # New Fund Center # New Personnel Sub Area # Begin Date Exempt Non-Exempt Fac/Acad Student Temp Choose New Status: BW Hours Grade Annual Salary Temp Hourly Rate Non-Exempt Hourly Rate Reason for Action Promotion Other (Please Specify Below) Yes No PO Position? Date Prepared Unpaid Personal Leave of Absence Return from Leave Workers Comp Leave Disability Leave Unpaid FMLA Leave of Absence Sabbatical Change of Hours Intradepartmental Job Transfer (Within Same Department) Ingrade Increase End Date of Temporary Assignment Increase Temporary Assignment Increase Correction to Salary Equity Increase / Market Adjustment Annual Increase Adjustment to Minimum Probationary Increase HRC # If this will result in a staff structure change, see page 2 End Date Reports To (Name/Title) Date Signature HR Solution Center Compensation Divisional Administrator Department Designee Department Administrator Approvals Organization Structure Update

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Page 1: Employee Change Form - Cornell University · Employee Change Form- Page 2 (for multiple org structure employee changes) Shaded fields are for HR-use only. Please submit your completed

Employee Change Form Shaded fields are for HR-use only. Please submit your completed form online at http://hrsc.weill.cornell.edu.

If organization change involves more than one reporting change, see page 2

Employee ID Number

Comments:

FTE

New Position Title

Work PhoneEmployee Name (Last, First, Initial) Bldg

Employee CWID

Floor Room Box #

Emp. Group

Current Position # Current Org. Unit Name / # Cur. Grade

ExemptNon-Exempt

Fac/AcadStudent

TempChoose Current Status:

Current Annual Salary Current Non-Exempt Hourly Rate Current Temp Hourly Rate

New Position # Emp. Subgroup

New Org. Unit Name / # New Fund Center # New Personnel Sub Area #

Begin Date

ExemptNon-Exempt

Fac/AcadStudent

TempChoose New Status:

BW Hours Grade Annual Salary Temp Hourly RateNon-Exempt Hourly Rate

Reason for Action

Promotion

Other (Please Specify Below)

Yes NoPO Position?

Date Prepared

Unpaid Personal Leave of AbsenceReturn from LeaveWorkers Comp LeaveDisability LeaveUnpaid FMLA Leave of AbsenceSabbaticalChange of HoursIntradepartmental Job Transfer (Within Same Department)Ingrade IncreaseEnd Date of Temporary Assignment IncreaseTemporary Assignment IncreaseCorrection to SalaryEquity Increase / Market Adjustment

Annual IncreaseAdjustment to MinimumProbationary Increase

HRC #

If this will result in a staff structure change, see page 2

End Date Reports To (Name/Title)

DateSignature

HR Solution Center

Compensation

Divisional Administrator

Department Designee

Department Administrator

Approvals

Organization Structure Update

http://hrsc.weill.cornell.edu
Page 2: Employee Change Form - Cornell University · Employee Change Form- Page 2 (for multiple org structure employee changes) Shaded fields are for HR-use only. Please submit your completed

Employee Change Form- Page 2 (for multiple org structure employee changes) Shaded fields are for HR-use only. Please submit your completed form online at http://hrsc.weill.cornell.edu.

Current Org Unit

Effective Date

Name: Position #:Current Manager:

To:

Parent Org Unit #:

Org Unit #:

Manager: Name: Position #:

Name Position # Employee ID CWID

Employees Moving:

http://hrsc.weill.cornell.edu

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