SOP 104.07-att-1: Position/Personnel Action Request Form (PA)

Division:
Administrative & Finance
Effective Date:
September 3, 2020
Reference Code:
IVO02-0001
Topic Area:
HR Applicant/Vacancy/Hiring/Position
PowerDMS:
View on PowerDMS
Length:
1,059 words

Summary

This form is used to document and request personnel actions within the Georgia Department of Corrections, including employee separations, transfers, and position changes. The form captures employee information, action reasons, supporting documentation requirements, and position/salary details. It is completed by facility staff initiators and reviewed by the Central Personnel Administrative (CPA) office for processing.

Key Topics

  • personnel action request
  • position action
  • employee separation
  • resignation
  • suspension
  • transfer
  • rehire recommendation
  • terminal leave
  • pay grade
  • position number
  • job code
  • FLSA code
  • DTI code
  • facility assignment
  • salary change
  • work schedule

Full Text

@gdc.ga.gov

SOP 104.07

EFFECTIVE DATE OF ACTION

GEORGIA DEPARTMENT OF CORRECTIONS
DATE
POSITION/PERSONNEL ACTION REQUEST

LOCATION PHONE

INITIATOR E-MAIL

Attachment 1

9/3/20

|EMPLOYEE INFORMATION|Col2|Col3|Col4|Col5|Col6|Col7|Col8|Col9|Col10|Col11|Col12|SUPPORTING PAPERS|Col14|Col15|Col16|Col17|Col18|Col19|Col20|Col21|COMMENTS|Col23|Col24|Col25|Col26|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
|Name|Name|||||||||||Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--|Correspondence (Resignation or Adverse Actions)
Suspension Notice
PIF/PMF
Min. Qual. Review Decision
DOL 800 Separation Notice
Other (Specify):
Is rehire recommended?
*If No, then attach supporting documentation
Terminal Leave Hours To Be Paid:
*Please attach verification
Last Day in Pay Status:
Does action impact a high security supplement?
0
--||||||
|Empl ID|Empl ID|||||||||||||||||||||||||
|SSN|SSN|||||||||||||||||||||||||
|Gender|Gender||Race|Race||||DOB||||||||||||||||||
|Maildrop ID|Maildrop ID|||||||||||||||||||||||||
||ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|ACTION
REASON
& DESCRIPTION|
|1||||||||||||||||||||||||||
|2||||||||||||||||||||||||||
|3||||||||||||||||||||||||||
|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|CPA USE ONLY|
|FLSA Code|FLSA Code|||||DTI Code|DTI Code|DTI Code||||||||||||||||||
|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|TO|FROM|FROM|FROM|FROM|FROM|FROM|FROM|FROM|FROM|FROM|
|Position Number|Position Number|Position Number||||||Classified
Indicator|Classified
Indicator|Classified
Indicator|Classified
Indicator|||||Position Number|Position Number|Position Number||||Classified Indicator||||
|Job Code|Job Code|Job Code||||||Job Title|Job Title|Job Title|Job Title|||||Job Code|Job Code|Job Code||||Job Title||||
|Department ID|Department ID|Department ID||||||Facility Name|Facility Name|Facility Name|Facility Name|||||Department ID|Department ID|Department ID||||Facility Name||||
|County
Code/Name|County
Code/Name|County
Code/Name||||||Zip Code|Zip Code|Zip Code|Zip Code|||||County
Code/Name|County
Code/Name|County
Code/Name||||Zip Code||||
|Pay Grade|Pay Grade|Pay Grade||||||Monthly Salary|Monthly Salary|Monthly Salary|Monthly Salary|||||Pay Grade|Pay Grade|Pay Grade||||Monthly Salary||||
|Pay Grade|Pay Grade|Pay Grade||||||% Change|% Change|% Change|% Change|||||||||||||||
|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|WORK SCHEDULE (DAYS & SHIFT)
BUDGET APPROVAL BY|
|1|2|3|4|5|6|7|8|9|10|11|12|13|14|15|--|---|---|Name|Name|||||Date||
|16|17|18|19|20|21|22|23|24|25|26|27|28|29|30|31|---|---|---|---|||||||
|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|COMPLETED BY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|APPOINTING AUTHORITY|
|Name|Name|||||||||||Date|Date|||Name||||||||Date||
|Name|Name|||||||||||||||||||||||||

Record Retention: Retain permanently in the official and local position/HR files.

Attachments (1)

  1. Position/Personnel Action Request Form (PA) (1,059 words)
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