b'Implement Company Policies with Ease Record and Communicate Payroll Changes$ 90 Payroll/Status Change NoticeA YEAR Payroll/Status Change NoticePlease Print PER APP Routing Payroll___________________ ___________________Please PrintUpdated option 68 16 New Hire Change SeparationRouting Payroll// ______________________________________Effective Date of Change _____________ SomnerJaniceChangedleSeparationavailable in Fill-and-SaveEmployee Name_____________________________________________________________________________________________//Effective Date of ChangeLast_____________New HireMidFirst xxx -xx-2412 12541AccountingEmployee Name_____________________________________________________________________________________________Social Security # _____________________________Employee/Payroll # ____________Dept. _____________________________format or as part of theLastFirstMiddleSocial Security # _____________________________Employee/Payroll # ____________Dept. _____________________________3641 Main RoadHollywoodFLTime & Attendance FormStreetCityState33321Address____________________________________________________________________________________________________ZIP Code 954 541-12 12 Street Date of Birth (for administrative use only) __________________/ / ZIP CodeAddress____________________________________________________________________________________________________()Telephone #_______________________________Library on page 13. Status:Full-Time TemporaryCityState Telephone #_______________________________ Date of Birth (for administrative use only) __________________/ /()Full-TimePart-TimePart-Time TemporaryOther ______________________ Clerk HourlyW-4 Attached? Yes NoStatus:Full-TimePart-TimeFull-Time Temporary Part-Time TemporaryOther ______________________Job Title _______________________________ Exempt Non-ExemptJob Title _______________________________ Exempt Non-Exempt HourlyW-4 Attached? Yes NoChange(s) for Current EmployeeChange(s) for Current Employee FromToCommentsType TypeFromToCommentsAddress Change _____________________________________________________________________________________________Address Change _____________________________________________________________________________________________Demotion _____________________________________________________________________________________________DemotionDepartment __________________________________________________________________________________________________________________________________________________________________________________________DepartmentFLSA Reclassification __________________________________________________________________________________________________________________________________________________________________________________________ FLSA Reclassification _____________________________________________________________________________________________ 401(k)/403(b) Contribution _____________________________________________________________________________________________I 401(k)/403(b) Contribution _____________________________________________________________________________________________ nsurance Eligibility _____________________________________________________________________________________________nsurance Eligibility _____________________________________________________________________________________________J I _____________________________________________________________________________________________ ob TitlePayroll/Status Change Notice Change of Insurance _____________________________________________________________________________________________ J _____________________________________________________________________________________________ ob TitleChange of Insurance _____________________________________________________________________________________________Employee InformationLayoff Layoff _____________________________________________________________________________________________ Length of Service Increase _____________________________________________________________________________________________Effective Date of Change__________________________of Service Increase/ / Length _____________________________________________________________________________________________Company Policies Smart App Name________________________________________________________________________________Employee/Payrol _____________________________________________________________________________________________Merit Increase# ______________________________Merit Increase_____________________________________________________________________________________________ _____________________________________________________________________________________________Position _______________________________________________ Salary Hourly Department_____________________________________ End of Introductory PeriodEnd of Introductory Period __________________________________________________________________________________________________________________________________________________________________________________________ Status: Ful-Time Part-Time Ful-Time Temporary Part-Time TemporaryPromotion _____________________________________________________________________________________________Promotion _____________________________________________________________________________________________ Other___________________________ Access 100+ mandatory, recommended and optional policies including specifics Reevaluation of Current Job _____________________________________________________________________________________________Reevaluation of Current Job _____________________________________________________________________________________________Change(s) for Current Employee Rehire _____________________________________________________________________________________________ Rehire _____________________________________________________________________________________________ for your state. Choose the attorney-approved policies you want to implement,Item #Price TypeFromToResignation _____________________________________________________________________________________________ Resignation _____________________________________________________________________________________________ Address Change ___________________________________________________________________________________________________________ etirement _____________________________________________________________________________________________R Change of InsuranceRetirement ________________________________________________________________________________________________________________________________________________________________________________________________________edit as needed to fit your companys culture, and create a policy handbook with DemotionSalary/Wage _____________________________________________________________________________________________ Salary/Wage _____________________________________________________________________________________________ ___________________________________________________________________________________________________________ DL2-SA900$90 per yearDepartment ___________________________________________________________________________________________________________Separation _____________________________________________________________________________________________ SeparationEnd of Introductory Periodhift Change _____________________________________________________________________________________________ ___________________________________________________________________________________________________________ease. Issue policies to individuals or the entire staff and, with automated tracking, FLSA ReclassificationShift Change _____________________________________________________________________________________________S _____________________________________________________________________________________________ ___________________________________________________________________________________________________________Insurance Eligibility ___________________________________________________________________________________________________________ ransfer _____________________________________________________________________________________________ T TransferJob Title ___________________________________________________________________________________________________________ _____________________________________________________________________________________________ see at a glance when employees have viewed each policy. Includes COVID-19 Length of Service IncreaseUnion Scale _____________________________________________________________________________________________Union Scale _____________________________________________________________________________________________ ___________________________________________________________________________________________________________ Web BasedMerit Increase ___________________________________________________________________________________________________________Other ______________Other ______________ Promotion ___________________________________________________________________________________________________________related policies including infectious disease and temporary remote work.Salary/WageLeave of AbsenceBegin Leave______________ Return from Leave ________________Leave of Absence Begin Leave______________Return from Leave/ // / / / ___________________________________________________________________________________________________________ / / ________________ Shift Change ___________________________________________________________________________________________________________Educational Personal Family/Medical Leave(Including Pregnancy) Transfer Educational PersonalFamily/Medical Leave(Including Pregnancy) ___________________________________________________________________________________________________________ Union Scale ___________________________________________________________________________________________________________Short-Term Disability Long-Term DisabilityOther ______________________________ Other _________________________Short-Term Disability Long-Term DisabilityOther _________________________________________________________________________________________________________________________________________Separation Separation Date/ / Last Day Worked/ / Last Day Paid/ /Separation__________________________________ _______________These productsComments____________________________________________________________________________________________________________________________________Separation Date _________________Last Day Worked _________________Last Day Paid _______________/ / / / / /_________________________________________________________________________________________________________________________________________________Involuntary SeparationNotice of COBRA Rights Provided on_____________/ /Learn more at hrdirect.com/smartappsVoluntary Separation Yes Involuntary SeparationNotice of COBRA Rights Provided on_____________/ /_________________________________________________________________________________________________________________________________________________ Voluntary SeparationElection of COBRANo Start Date of Coverage_______________/ /comply with the Leave of AbsenceBegin Leave______________________Return from Leave______________________ Election of COBRA YesNo Start Date of Coverage_______________/ /// // If yes, describe type of coverage elected:_____________________________________________________________________________ Educational Personal Family/Medical Leave (including Pregnancy)If yes, describe type of coverage elected:_____________________________________________________________________________U.S. Supreme Court Short-Term Disability Long-Term Disability Other_______________________________________ Additional Comments________________________________________________________________________________________________ Additional Comments________________________________________________________________________________________________// // // __________________________________________________________________________________________________________________________ SeparationSeparation Date ______________________Last Day Worked______________________Last Day Paid________________________decision on LGBTQ Voluntary Separation Involuntary Separation Notice of COBRA Rights Provided on_________________________ (Optional)_________________________________________________________________________Date __________________________________________________________________________________________________________________________________________////Election of COBRA YesNoStart Date of Coverage______________________ / /If yes, describe type of coverage elected:______________________________________________________________________ Employee Signature _________________________________________________________________________/ /discrimination in theAuthorizations ___________________________ (Optional) Name and Title Date ________________Employee SignatureName and Title/ /Supervisor/Designated Manager Signature_____________________________________________________________Date ________________Name and Title / /Supervisor/Designated Manager Signature_____________________________________________________________Date ________________workplace. Employee Signature (optional)______________________________________________________________________________Date_____________________ Human Resources/Payroll Manager Signature ___________________________________________________________Date ________________// Name and Title / /// / /Supervisor/Manager Signature_____________________________________________________________________________ Date_____________________ Name and Title Date ________________Human Resources/Payroll Manager Signature ___________________________________________________________ Name and Title// This rpvg iocuest.oTf hteh ei nufsoer mor inability de accurate and authoritative information. However, itti tiysinnovto al vseudb sinti tcurteea tfoinrg l,e gparol daduvciicnegaonr dd disoterisb nuotiyn gsp tehciisf ipcr oqduuesctti ons or c obnlcee fronrs a ynou may ha Human Resources/Payroll Manager Signature_____________________________________________________________ Date_____________________o roduct is designedat itoo np riso vpir toov iudseed t hwiist hp rtohdeu ucnt.d Yeorsut aanrde iunrgg ethda tto a cnoyn psuerlts oannoartt eonrney concerning your particular situation and an t provide legal opisin nioont lsi ao n any speyc idfiacm faacgtessve.arri sseinThis product is designed to provide accurate and authoritative information. However, it is not a substitute for legal advice and does not provide legal opinions on any specific facts or services. The information is provided with the understanding that any person or entity involved in creating, producing or distributing this product is not liable for any damages arising out of the use or inability to use this product. You are urged to consult an attorney concerning your particular situation and any specific questions or concerns you may have.Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties.Routing: Payrol ____________________________________________________ ____________________________________________________A22011668 ComplyRight, Inc. Important note: This is approved for use by the purchaser only. This form may not be shared publicly or with third parties. Two easy ways to reorder: hrdirect.com800-999-9111A22011668 ComplyRight, Inc. Two easy ways to reorder: hrdirect.com800-999-9111This product is designed to provide accurate and authoritative information p. rHooviwdeevde wr, iitth i st heno tu an dsuebrssttaitnudtien gfo trh laegt aaln ayd pveicreso ann od rd eonetsit ny ot pinrvoovlivdeedleing acrl eoaptiinnigo,n psr oodn uacniyn gs poer cdifisict rfiabcuttsi nogrtsheirsv picreosd. uTchte i sin nfootr mliaabtiloen f oisrs aitnuya tdiaonm aangeds a anryi ssinpge coifuictoqfu tehset iuosnesoorricnoanbcielitryn tso y uosue m thaiy have.s 22107220C CFoLmplyRight, Inc. propdourtcatn. Yto nuo taer:e T uhrigs eisd a tpop croonvseudl tf oarnuasteto bryn ethy ec opnucrecrhnaisnegryoonulyr .p Tahristi cfourlamrmay not be shared publicly or with third parties. 3-Part CarbonlessA ImEssential Workplace PoliciesFill-and-Save FormatEstablish and implement policies to address a variety of workplace issues. Choose from 50+ attorney-developedComplyRight policies on topics ranging from overtime to discriminationPayroll Formsand harassment. Policies can be printed for distribution, emailed to employees or both. Employee acknowledgmentsDocument all job and salary changes, including document that employees have been notified. reclassification, transfers and promotions. List new hire information, leave of absence and separation data.DescriptionItem #PriceDescriptionItem #Price Ensure employee files have updated, current payrollPayroll/Status Change NoticeDownloadableDL2- A3016$100 records. 3-Part CarbonlessDL2-A2168$82.95CDDL2-A3016CD$110 DownloadableStandard FormDL2-A2172$49.95Carbonless form instantly provides copies for Fill-and-Save FormatDL2-A2172CFL$32.95the employee, supervisor and HRs personnel files Price per pkg/50. Standard: 8" x 11", Compact: 5" x 8"Includes a ComplyRight guide to help you documentjob and salary changes the right way Fill-and-Save item22 WORKPLACE MANAGEMENTPOLICIES & PAYROLL HRDIRECT.COM800.999.9111 23'