Spreadsheet: 9c95b0ed-78b3-4c47-ab91-e8c5636046bf
Sheet: Sheet1

Unnamed: 0 | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4
CITY OF FLAGSTAFF
PERSONNEL CHANGE REQUEST
INSTRUCTIONS
1) Complete form in its entirety
2) Complete additional forms/documents as required
3) Route for approvals
4) Make a copy for future reference
5) Submit to Human Resources after all signatures have been obtained
Name of [NAME] |  | Date
Division Name |  | Section Name
REQUEST
Request is for     Mid Year* (effective after work is complete)     Fiscal Year (effective 7/1 of next fiscal year)
Reclassification/Rerange - Also submit:  1) Job Analysis Questionnaire  2) Current org chart and  3) Proposed org chart
Reorganization - Also submit:  1) Job Analysis Questionnaire  2) Current org chart and  3) Proposed org chart
Rezone - Also submit:  1) Zone Change Form and  2) Zone Change Checklist (as required on Zone Change Form)
Retitle - List details under "Staff" section
Addition of Position - Also submit:  1) Job Analysis Questionnaire  2) Current org chart and  3) Proposed org chart
New classification or     Existing classification
Full-time or     Part-time (# of hours                )
Job Consolidation - Also submit:  1) Job Analysis Questionnaire  2) Current org chart and  3) Proposed org chart
Change From Temp to Perm
Change in number of hours (from                to                )
Assignment Pay - Also submit:  1) Assignment Pay Request Form
[NAME]
Explain why you are requesting this change (include current and future needs, statistical and analytical information, etc.)
PROPOSAL
Reclassification/Rezone/Reorganization of employees (regular and temp).
STAFF
List all positions that will be impacted by the personnel changes.  All new positions should appear in the proposed column only.
 | CURRENT |  | PROPOSED
Name | Position Title | Range | Position Title | Range
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
 | Account #: |  | Account #:
COST ESTIMATE
One time vs. ongoing.  If necessary, attach Excel spreadsheet with details.
Description | [NAME] |  | Cost | Check if 1X
Staff Cost
ERE (hover for position details)
Other Expenses/Supplies/ Equip/Training/Etc.
Other
TOTAL |  |  | 0
*For all requests outside of the annual budget process, you must provide a funding source for the current year as well as an ongoing cut to your base budget to fund future years. These requests will be reviewed by Finance and budgets will be adjusted accordingly.  Please explain or list details here:
DIVISION APPROVALS  NOTE: All approvals must be completed before submitting to HR for review.
Recommendation |  |  | Signature | Date
Supervisor:                            Approved          Not Approved    _____________________________________________________
Comments:
Section Head:                       Approved          Not Approved    _____________________________________________________
Comments:
Division Director:                 Approved          Not Approved    _____________________________________________________
Comments:
Deputy City Manager:         Approved          Not Approved    _____________________________________________________
Comments:
FINANCE APPROVALS
Recommendation |  |  | Signature | Date
Finance:                                 Approved          Not Approved    _____________________________________________________
Comments: