Title Page
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Employee Name (Legal Name)
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Position or Title
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Social Security Number
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Effective Date
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District
Employee Status
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New Hire
- Introductory
- Full Time
- Part Time
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Re-Hire
- Full Time
- Part Time
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Change Status to:
- Full Time
- Part Time
- Terminated
- Lay-off
- Quit
Pay Rate
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Introductory Rate (if applicable)
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Full-Time Rate
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Change Pay Rate (increase or decrease)
Position or Location Change
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Transfer to New Location
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Change Job Title
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Address and/or Phone Number Change
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Comments/Reason for Termination or Quitting
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Authorized By
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* If this change requires approval, please copy your direct manager.