Recommendation for PERSONNEL ACTION FORM EmployeeLast NameFirst NameInstructionsCheck the appropriate box and fill in the information in the blanks below. Employees signs only if he or she initiates actions or payroll deductions is required. Manager signs in all cases.ChooseIncreaseDecreaseClassification change TransferPromotion Leave of AbsenceSeparationPayroll deductionChange of AddressChange in dependentsOtherChange in Pay or ClassificationFROMPay/perClassificationTOPay/perClassificationEmempt?TO BE EFFECTIVESeparationLaid off for lack of workLeft work voluntarilyDischarge for willful misconductDischarged for felonious conductOther reasonRemarks(Final paycheck, date, amount, etc.)Eligible for rehire?YESNOOther (Changes, deductions etcs)?EmployeeDateManagementDateSubmit
