Student Employee Job Data Change Form
This form is to be completed by the Supervisor, Department Chair
or Designee. Complete the written documentation and authorization
of the requested transaction below. Forward all requests for
student assistant transactions to the appropriate Financial Manager
for authorization. Retention of this form should be determined by
the Financial Manager. Forward all requests for Work-Study students
to the Work-Study Office. If data input assistance is needed,
forward all requests to Payroll/HR Systems, University Hall, Room
165 or Mail Code 8229, FIVE DAYS PRIOR to student time entry into
PEOPLESOFT. Questions regarding this form may be directed to
[email protected].
I. STUDENT INFORMATION: Employee Name:
_______________________________________ CSUN ID: ____________
Current Department ID: _____________ Current Job Code: ______
Student Assistant Work-Study Student
II. JOB CHANGE INFORMATION: Effective Date:____________________
Reason for Change:
New Department From: ______________________________ To:
_________________________________
New Job Code From: ______________________________ To:
_________________________________
From: ______________________________ To:
_________________________________ Class Level *
For Work-Study Only: Previous Job ID: ______________________ New
Job ID: __________________________
Hourly Rate: From: $_____________________________ To:
$________________________________
Separate from Department: Department ID: _____________
Pay Changes: (Check one reason for change)
Change in Class (Current Job Re-classified) Promotion (New Job
in Higher Class)
Merit Increase (List six qualifying months of satisfactory
performance):
___________ ___________ ___________ ___________ ___________
___________ Exceptional Performance Increase (Must Include
Justification)
Special Notes:
III. APPROVALS:1. STUDENT ASSISTANTS: This form must be approved
by the appropriate FINANCIAL MANAGER prior to student time
entry
into PEOPLESOFT.
2. WORK-STUDY: *(Note: only required for class level change)
This form, a Job Request form and a new Work-Study Authorization
must be on file or received by the Work-Study Office TEN DAYS PRIOR
to student time entry into PEOPLESOFT.
Supervisor/Department Chair: ____________________________Print
Name: ___________________ Date: __________
Director/Dean/MAR: ___________________________________ Print
Name: ___________________ Date: ___________
Work-Study Program Manager:___________________________ Print
Name: ___________________ Date: ___________
Process Date: _____________ Initials: ______________
OHRS Form 20-57 (Rev. 2/22/2013)
mailto:[email protected]
CSUN ID: WORK-STUDY STUDENT: OffNEW DEPARTMENT: OffNEW JOB CODE:
OffCLASS LEVEL: OffHOURLY RATE: OffSEPARATION: OffCLASS CHANGE:
OffPROMOTION: OffMERIT INCREASE: OffSTUDENT ASSISTANT:
OffEXCEPTIONAL PERFORMANCE: OffSPECIAL NOTES: PRINT CHAIR NAME:
PRINT MAR NAME: PRINT MANAGER NAME: MERIT1: MERIT2: MERIT3: MERIT4:
MERIT5: MERIT6: FROM HOURLY RATE: TO HOURLY RATE: EMPLOYEE
INFORMATION: CURRENT DEPARTMENT ID: CURRENT JOB CODE: EFFECTIVE
DATE: FROM NEW DEPARTMENT: TO NEW DEPARTMENT: PREVIOUS JOB ID: NEW
JOB ID: FROM CLASS LEVEL: TO CLASS LEVEL: FROM NEW JOB CODE: TO NEW
JOB CODE: DEPARTMENT ID:
