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Fillable Employee Status Change Template

The Employee Status Change form is a document used by organizations to officially record changes in an employee's status, such as promotions, demotions, transfers, or terminations. This form ensures that all relevant information is accurately updated in the company’s records. To maintain accurate employee data, it is essential to fill out this form promptly; click the button below to get started.

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Fillable Employee Status Change Template

Content Overview

File Details

Fact Name	Description
Purpose	The Employee Status Change form is used to document any changes in an employee's status, such as promotions, demotions, transfers, or terminations.
Required Information	This form typically requires details such as the employee's name, ID number, the nature of the change, and the effective date of the change.
State-Specific Forms	Some states may have specific requirements or forms. For example, California requires adherence to the California Labor Code, which governs employee records and changes.
Retention	Employers must retain completed Employee Status Change forms for a specified period, often for at least three years, in accordance with federal and state employment laws.

Sample - 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:_______________________

Common mistakes

Filling out an Employee Status Change form can seem straightforward, but many people make common mistakes that can lead to confusion or delays. One frequent error is leaving out essential personal information. This includes details like the employee's full name, job title, or employee ID. Omitting any of this information can result in processing delays or even incorrect changes being made.

Another common mistake is failing to specify the reason for the status change. Whether it's a promotion, transfer, or resignation, clearly stating the reason helps HR understand the context. Without this information, the change may not be processed correctly or might lead to misunderstandings later on.

Many individuals also overlook the importance of checking the dates associated with the change. Providing the correct effective date is crucial. If the date is incorrect, it can cause payroll issues or affect benefits eligibility. Always double-check the dates before submitting the form.

Not obtaining the necessary approvals is another pitfall. Many organizations require a supervisor's or manager's signature before processing a status change. If this step is skipped, it can delay the entire process. Ensure that all required approvals are in place to avoid unnecessary hold-ups.

Another mistake is neglecting to read the instructions carefully. Each organization may have specific guidelines for filling out the form. Ignoring these can lead to errors. Take the time to review any provided instructions to ensure compliance with company policy.

People often forget to keep a copy of the completed form for their records. This can be problematic if there are questions or discrepancies later on. Keeping a copy can provide clarity and serve as a reference point in case issues arise.

Finally, some individuals submit the form without reviewing it for accuracy. Typos or incorrect information can lead to significant complications. Before sending the form, take a moment to proofread it. This simple step can save time and prevent frustration down the line.

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