This form is submitted by the Hiring Supervisor to Human Resources to:

Report a New LTE Hire (includes former LTEs new to a position) from an approved Position Requisition

Report a New LTE Position of a current (not laid off) LTE from an approved Position Requisition (PR)

Reactivate a former LTE to the same position last held in same or prior calendar year only with approved PR

Request a Pay Change (for LTE positions w/ pay latitude) for current LTE, after necessary approvals received

This form cannot be used in lieu of a PR for new or reactivated hires or appointments. Reference Recruitment Policy Sections VIII.E.2 & 3 for specific information (and timeframes) on using this form to report filled positions.

EMPLOYEE NAME:	POSITION REQUISITION #: (for all hires & new positions)

TRANSACTION INFORMATION
Effective Date	NOTE: Effective Date is the first day of actual work for new/reactivated hires and the first Sunday of the next pay period for current employees. All Pay Changes are effective the first pay period following receipt by HR
Transaction Type
New Hire to WSFP New Position for Current LTE concurrent with another active Position Pay Change* New Position for Current LTE and Terminate Old Position # (see note below): * in current position NOTE: if old position was in another dept., inform the other dept. to submit a Termination Report Reactivate former LTE terminated in same or prior calendar year only to same position last held

POSITION INFORMATION – All Fields Required, except *Current Pay Rate for (re)/hires & ^last four fields for pay changes
Position Title	Position Number	Department/Unit	Dept. Fund ID
New	Current	Report to (Name)^	Work Location (i.e. Grandstand,	Shift Hours^	Approx. #
Pay Rate $	Pay Rate* $	Guest Svcs, Hort. Bldg, etc.)^	Start: End:	Hrs/Wk^

EMPLOYEE PROFILE – complete for new hires only. May attach application/resume copy (keep original) for duplicated fields
Street Address	City	Zip	Under 18 on Hire?	STAR?
Yes	Yes
Phone Number(s) – primary first	Work Phone # (if assigned)	Email Address (WSFP-issued or personal, if no WSFP)

PAY CHANGE JUSTIFICATION ONLY – Provide justification for pay change for those few positions approved for pay latitude
Is funding in salary line? Yes No how will you fund?

APPROVALS – Electronic signatures allowed for lines 1 - 3 if HR receives via email directly from the highest level signed
Hiring Supv:	Date:
Pay Changes Require the Following Signatures:	If Denied, Check:
Dept Head:	Date:	Denied HR
Div Head:	Date:	Denied HR
HR:	Date:	Denied HR
CEO:	Date:	Denied HR