Download Employee Status Change Form in PDF

The Employee Status Change form is a crucial document used by organizations to formally record changes in an employee's status, such as promotions, transfers, or terminations. This form ensures that all relevant departments are informed and can update their records accordingly. Understanding how to properly complete and submit this form can streamline processes and maintain accurate employee records.

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The Employee Status Change form serves as a crucial document in the workplace, facilitating the smooth transition of employees through various stages of their employment journey. This form is typically utilized when there are changes in an employee's status, such as promotions, demotions, transfers, or terminations. By documenting these changes, the form helps ensure that all relevant parties are informed and that the necessary adjustments are made in payroll, benefits, and other administrative systems. Additionally, it often requires the input of both the employee and the employer, fostering clear communication and mutual understanding. As organizations evolve and adapt to new challenges, the Employee Status Change form plays a vital role in maintaining accurate records and supporting a healthy work environment.

Document Data

Fact Name	Description
Purpose	The Employee Status Change form is used to document changes in an employee's status, such as promotions, demotions, or terminations.
Required Information	Typically, the form requires the employee's name, employee ID, date of change, and details regarding the change.
Submission Process	Employees or managers must submit the form to the HR department for processing. Timeliness is crucial to ensure accurate record-keeping.
State-Specific Forms	Some states may have specific forms or additional requirements. For example, California requires adherence to the Fair Employment and Housing Act (FEHA).
Record Keeping	Employers must retain these forms as part of the employee's personnel file for a specified period, often dictated by state law.
Impact on Benefits	Changes in employment status can affect benefits eligibility. It is important for employees to understand how their status change may impact their benefits.
Legal Compliance	Employers must ensure that the use of the form complies with applicable labor laws, including those related to discrimination and employee rights.

How to Write Employee Status Change

After obtaining the Employee Status Change form, you will need to complete it accurately to ensure a smooth processing of the changes. Follow these steps to fill out the form correctly.

Begin by entering the employee's full name in the designated field.
Provide the employee's identification number or social security number as required.
Indicate the current job title of the employee.
Specify the new job title if applicable.
Fill in the effective date of the change.
Check the appropriate box to indicate the type of status change (e.g., promotion, demotion, transfer, termination).
Provide a brief explanation for the status change in the comments section.
Sign and date the form at the bottom to confirm the information is accurate.
Submit the completed form to the HR department for processing.

Employee Status Change Example

Employee Status Change Form

Employee Name: ___________________________________________________ Social Security #: __________________________________

Address: ______________________________________________________________________________________________________________

DT #: ___________ Location Name: _________________________________ Position: ____________________________________________

Effective Date: ______/______/______		Date of Birth: ______/______/______ E-mail: ________________________________________

Employee Status
Type of Change:	New Hire		Rehire	Employee Status Change
Regular Full Time	(30 hours or more)		Hours per week: _________
Regular Part Time	(29 hours or less)		Hours per week: _________
Temporary	(Less than 6 months)		Hours per week: _________
On Call	(As Needed)

Salary Establishment/Change
Type of Change:		New Hire		Merit Increase		Promotion		Cost of Living		Other _______________________
New Pay Rate:	$__________________			per hour		Bi-weekly salary amount			Annual Salary $______________________
				(Non-Exempt)		(Exempt)			(If Exempt)
IF SCHOOL EMPLOYEE: ( If contracted teacher, please attach a copy of the contract)
# of Pays: _____________		First Check Date: ______/______/______						Final Check Date: ______/______/______


Status Change
Location Change (Transfer)				From_______________________________ To ________________________________
Position Change				From_______________________________ To ________________________________
Leave of Absence				From_______________________________ To ________________________________
Other				_______________________________________________________________________

Termination of Employment
Last Working Day: ______/______/______
Eligible for rehire?	Yes	No (if no, list reason) _______________________________________________________________
Select ONE reason for separation:
Voluntary:
Dissatisfied w/ job or company			Retirement		School		No Call/No Show			Better job/pay/benefits/hours
Medical-self or family			Relocating		Family issues		Other________________________________________________
Involuntary:
Poor performance				Gross Misconduct			Contract Ended			Unqualified for job
Violation of company policy/procedure				Unprofessional conduct			Other________________________________________________

Remarks:______________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________

Parish/School/Agency Signature:______________________________________________________________ Date:_______________________

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