PAYROLL CHANGE FORM PAYROLL CHANGE FORM Store InformationStore LocationQueen StCreameryBanffWhistlerNOTLQuebecAvonleaCavendishGatewayHalifaxHalifax KioskNFLPeakesAction Type Hiring Rehiring Termination Other If Other:Effective Date* Date Format: MM slash DD slash YYYY PERSONAL INFORMATIONEmployee Name First Last First Day Worked Date Format: MM slash DD slash YYYY Employee Email Address Job TitleScooperRetail AssociateIce Cream SupervisorRetail SupervisorAssistant ManagerIce Cream ManagerRetail ManagerStore ManagerDepartment (Check All That Apply) Ice Cream Retail Employment Type (Status)Full TimePart TimeSeasonalStudentCasualRate Of Pay* If Existing Rate is Changing, Please Explain BrieflyWork Permit Number (Optional)Work Permit Expiry (Optional) Date Format: MM slash DD slash YYYY TERMINATION / LEAVEEmployee Name First Last Last Day Worked Date Format: MM slash DD slash YYYY ReasonQuitReturn to SchoolEnd of SeasonShortage of WorkLeave*DismissalWork Visa ExpiryCommentsREHIRERehirable Yes No ** Notice Pay Yes No Leave TypeIllness/InjuryMaternityParentalCaregiverPersonalOtherCommentsAUTHORIZATIONStore Manager / Hiring Manager Name First Last Date Date Format: MM slash DD slash YYYY FOR PAYROLL ONLYEmployee #ESS Access Setup Activated Suspended ROE Issued Yes CommentsPayroll/Operations SignatureDate Date Format: MM slash DD slash YYYY