Employee Status Change Form in PDF

The Employee Status Change form is a crucial document used by organizations to officially record any changes in an employee's status. This form can address various transitions, including promotions, transfers, or terminations. Understanding how to properly complete and submit this form is essential for both employees and employers to ensure accurate record-keeping and compliance.

Access Editor Here

The Employee Status Change form plays a crucial role in managing workforce dynamics within an organization. This form facilitates various transitions in an employee's career, including promotions, demotions, transfers, and terminations. By documenting these changes, employers ensure compliance with company policies and maintain accurate records for payroll and benefits administration. Additionally, the form often requires detailed information about the employee, such as their current position, the new status being requested, and effective dates. Proper completion of this form is essential, as it triggers necessary updates in the employee's file and informs relevant departments, such as Human Resources and Payroll, about the changes. Understanding the importance of this form can help both employees and employers navigate the complexities of employment status adjustments with clarity and confidence.

Document Characteristics

Fact Name	Description
Purpose	The Employee Status Change form is used to document any changes in an employee's status, such as promotions, demotions, terminations, or leaves of absence.
Importance	Accurate documentation through this form helps maintain up-to-date records for payroll, benefits, and compliance with labor laws.
Submission Process	Typically, the form must be submitted to the Human Resources department for processing and record-keeping.
State-Specific Requirements	Some states may have specific laws governing employee status changes, including notification requirements. For example, California’s Labor Code Section 2922 addresses employment termination notices.
Confidentiality	Information contained in the form is generally considered confidential and should be handled according to company privacy policies.
Signature Requirement	Many organizations require signatures from both the employee and their supervisor to validate the changes being made.
Time Sensitivity	Timely submission of the form is crucial, as delays can affect payroll processing and employee benefits.
Record Keeping	Employers are typically required to retain copies of the Employee Status Change form for a certain number of years, depending on state laws.
Training and Awareness	Employees should be trained on how to properly complete the form to ensure that all necessary information is provided and accurate.

Example - Employee Status Change Form

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:_______________________