PAYROLL CHANGE FORM

PAYROLL CHANGE FORM

Store Information
Store Location
Action Type
- Hiring
- Rehiring
- Termination
- Other
If Other:
Effective Date*
Date Format: MM slash DD slash YYYY
PERSONAL INFORMATION
Employee Name
First Last
First Day Worked
Date Format: MM slash DD slash YYYY
Employee Email Address
Job Title
Department (Check All That Apply)
- Ice Cream
- Retail
Employment Type (Status)
Rate Of Pay
* If Existing Rate is Changing, Please Explain Briefly
Work Permit Number (Optional)
Work Permit Expiry (Optional)
Date Format: MM slash DD slash YYYY
TERMINATION / LEAVE
Employee Name
First Last
Last Day Worked
Date Format: MM slash DD slash YYYY
Reason
- Quit
- Return to School
- End of Season
- Shortage of Work
- Leave*
- Dismissal
- Work Visa Expiry
Comments
REHIRE
Rehirable
- Yes
- No
** Notice Pay
- Yes
- No
Leave Type
Comments
AUTHORIZATION
Store Manager / Hiring Manager Name
First Last
Date
Date Format: MM slash DD slash YYYY
FOR PAYROLL ONLY
Employee #
ESS Access Setup
- Activated
- Suspended
ROE Issued
- Yes
Comments
Payroll/Operations Signature
Date
Date Format: MM slash DD slash YYYY