Employment Change Request
New Employee
Employee Name
*
Department
*
Please Select
Auditor
Building Maintenance
Commissioner's Court
Constable
County Clerk
County Court at Law #1
County Court at Law #2
County Judge
District Attorney
District Clerk
District Courts
Domestic Relations
Elections
Extension
Fire Department
HR/Payroll
Information Technology
JP #1
JP #4
Judicial Enforcement
Juvenile Probation
Managed Assigned Counsel
Purchasing
Road and Bridge
Sheriff's Department
Tax A/C
Treasurer
Youth Center of the High Plains
Employment Type
Full Time
Part-Time
Exempt
Temporary
Effective Date
*
/
Month
/
Day
Year
Date
Range
*
/%
*
Position
*
Annual Salary
*
Bi-Weekly Salary
Replacement For
Email Address
example@example.com
Fund
blanks
*
Dept#
blank
*
Uniform Allowance
*
Please Select
Not Applicable
$50.00 per month
$75.00 per month
Phone Allowance
Please Select
Not Applicable
$25.00 per month
$35.00 per month
Badge Number
(if applicable)
Kronos Status
Time Off Approver 1
Time Off Approver 2
Time Sheet Approver 1
Time Sheet Approver 2
Time Sheet Approver 3
Comments
Department Head Email Address
*
example@example.com
Completed by Email Address
*
example@example.com
Completed By Signature
*
Date
*
/
Month
/
Day
Year
Date
Department Head Approval Signature
Date
/
Month
/
Day
Year
Date
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Submit
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