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PERSONNEL ACTION FORM
 

 
Please indicate if action to be taken is regarding new employment or completion of probation:
 
Employment Type:
Existing Employee, new position or promotion

Requested Action

  Existing Employee: Jussiah Lopez
  Position: FTO Supplemental Pay
  Pay Rate: $1,000.00 Annually
  Salary Budget Area: 1000-0560-4062
  Start Date: October 26, 2026
  Physical:  N/A
  Drug Test: N/A