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N OF <br /> T[IEDS <br /> PERSONNEL ACTION NOTICE <br /> W Employee Identification <br />'Jame: Kitty Hickok Home Phone: 429-4298 <br /> ' Soc. Sec. <br /> kddress: 4299 Oakmede Lane , White Bear Lake , 5511flj1mber 476-88-0262 F <br /> Date Appointed <br />'osition: Payroll Clerk to Current Position 2/16/88 , <br /> Department: Finance Date of Hire: 2/16/88 <br /> Effective Date <br /> Date of Form: 4/10/92 of Action: 4/14/92 <br /> PURPOSE OF ACTION: Employee Identification Change❑ Step Change 0 <br /> Job Classification Change❑ Resignation❑ Layoff❑ Dismissal❑ Other(2r ---- <br /> COMMENTS: <br /> �COMMENTS: Step 4 Adjustment <br /> EMPLOYMENT STATUS RETIREMENT EXEMPTIONS [ <br /> Temporary/Seasonal Employment: ❑ Check if: <br /> Estimate end date Appointment is not to exceed six € <br /> Part-Time ❑ consecutive months. ❑ <br /> Estimate Hours/WeekEmployee's annual compensation will <br /> Regular not exceed $5100 in a calendar year ❑ <br /> Employee is a full-time student enrolled in and <br /> attending classes at an accredited school ❑ <br /> WAGE INFORMATION UNION WAGE/BENEFIT-EXEMPTION <br /> Hourly Monthly ' Step Other Check if employee is in a union shop <br /> and will work less than: <br /> Old 2-1-4-9 . 71 3 <br /> 67 days in a calendar year, or ❑ <br /> New 2269 . 14 4 <br /> 100 days in a calendar year, Is under the age <br /> Date of last wage change 1/1/92 of 22 and a full-time student who will be <br /> enrolled in a public or private institution. ❑ , <br /> Code Employment Cost 100-4150-010000 J 4 <br />• / 00 41'20 010000 <br /> 73 20- 0000 <br /> SIGNATURES: Employee City Manager <br /> LDepartment Head ' , Hance Director ..941/4 ci.- J <br /> OFFICE USE ONLY <br /> DRIVER'S LICENSE NUMBER Application Complete 0 <br /> EMPLOYEE NUMBER Immigration Form U J <br /> WHITE-FINANCE YELLOW-CITY MANAGER PINK DEPARTMENT HEAD GOLDEN ROD-EMPLOYEE <br />