Missouri State University

Personnel Action Form

PERSONNEL ACTION FORM

Personnel Action forms should be printed on 6-part NCR paper, which can be obtained from Printing Services

Instructions for loading and printing NCR paper:

Carbonless copy paper or NCR paper (No Carbon Required paper) is coated on one side with a substance that will allow transfer of signatures or other markings to the paper below it; it is important to print on the uncoated side of the paper so that signatures will transfer to copies below it.  The packaging material should have an arrow indicating which side is up (uncoated); you may have to test which side is coated by making an inconspicuous mark in a corner of the paper.  The information for the PAF should be printed on the uncoated side of a set of six NCR papers (goldenrod, pink, yellow, green, blue, and white).  Do not change the order of the colored papers after they are removed from the packaging as they are packaged in the correct color order.   The manner in which you place them into the printer (coated side up or down) will vary by printer and feed method. 

After the PAF copies are printed, place them in the correct order by arranging the papers with the uncoated sides up in the following order starting at the top: white, blue, green, yellow, pink, and goldenrod.  Approvers will sign the white copy with the signature transferring through to the copies below. 

INSTRUCTIONS FOR COMPLETING PERSONNEL ACTION FORM

The Personnel Action Form (PD-003) is used to report appointments, terminations, a change in status, or compensation of an individual employee. The Personal Action Form should be used each time there is an action that should be recorded in the individual's personnel file or that requires payroll action.  Use it as a transmittal form for approval of the personnel action.  Attach to the form all available supportive materials such as:

 

  • Appointments - application, resume, official transcripts, letters of recommendation, W/4, I-9, direct deposit, etc.
  • Resignations/Retirements - letter from employee or standard resignation form.

 

Section I Personal Information - Enter information about the employee. Always identify an employee by full name, including the middle initial or middle name.  A social security number is only needed for the initial appointment of a new employee; after the initial appointment, please enter the BearPass Number.  Indicate the name of the employee’s home department and the org number to which the employee is assigned. The rest of the information in this section may not be necessary except for the initial appointment of a new employee

 

The PAF should not be used to communicate changes in names, addresses, or telephone numbers.  Please have the employee contact HR to make those changes themselves.

 

Indicate who the employee is replacing unless this is a new position that has not existed before. 

 

Section II Classification - Indicate the employee’s job title and the date the personnel action is to be effective.  Indicate the type of employee among the choices available.

 

Section III Assignment Status - Indicate whether full or part-time, the appointment period (if applicable), the full-time equivalent (FTE) by comparing with a standard 40-hour work week or a 12 credit-hour academic teaching load, and the dates of the appointment (if applicable).

  • Full-time 75% or above, eligible for full benefits
  • Part-time 51% - 74%, eligible for participation in MOSERS or CURP retirement system
  • Part-time 50% or less, regular
  • Part-time 50% or less, occasional, irregular, or short-term assignments   

 

Section IV Nature of Action - Use checkboxes to indicate all actions that apply. Provide any information which would explain action being taken.

 

If action is for supplemental pay, include in Section VIII Justification or Comments:

 

  • Description of Services - nature of project and participant’s activities.
  • If grant or contract - percent of time or credit hour equivalent.

 

Section V Form Information - Indicate the date this form was prepared, the name of the person completing the form, and whether this is a new form or a revision to a previously submitted PAF.  If this is a revision, please explain what is being revised.

 

Section VI Time and Leave Reporting and Approval - Indicate who will approve Time Sheets or Leave Reports for this employee and provide the Approver’s TS Org number.  Indicate whether the employee will enter their own time and leave (Web Time Entry) or whether the department will enter time worked (Departmental Time Entry). 

 

If this employee will be a Time Sheet Approver, Leave Report Approver, or Departmental Time Entry Originator, complete the online Web Time Entry Approver/Departmental Time Originator Authorization Form to initiate the set up to ensure the payroll approval process continues for employees affected by the change.   This form must be completed to set-up both interim approvers as well as the permanent approver once the vacant position is filled.

 

Section VII Salary Information - Indicate the amount of compensation and whether the amount listed is an annual, hourly, semester, one payment, or monthly amount.  An hourly pay rate must be provided for nonexempt employees.  Indicate the FOAP (Fund, Organization, Account, and Program) to be charged for the employee’s salary (and the percent charged when more than one FOAP is used).

 

Section VIII Justification or Comments - Provide any information that will explain or clarify the personnel actions listed on this form.

 

Section IX Approval - Space for required signatures.

 

-NOTE-

 

Offers of employment to faculty and staff are contingent upon the Board of Governors approval.

 

The originator will be notified of approval by receiving a signed copy of this form. Please review the returned copy to determine if any changes have been made after the form was initiated.

 

PAYROLL DEADLINE: This form must be completely executed and received in the Office of Human Resources by the 20th of the previous month for the 15th of the month paycheck and the 5th of the month for the paycheck issued on the last day of the month.

 

After completing form, print on 6-part colored NCR paper for appropriate distribution by the Office of Human Resources after form has received final approving signature.

 

An Equal Opportunity/Affirmative Action Employer