4

Reference AT160072

PERSONNEL ACTION FORM

 

 

 

 

DEPARTMENT WV ATTORNEY GENERAL Employee Org 1500
DIVISION FACILITY
EMPLOYEE NAME Henderson Lance Social Security 
Last First Generation
99 av Iate Zip County

RACE 501981

DATE OF BIRTH 04-19-1964 SEX

TRANS CTION MATION
Transaction Code Cause Annual Sala

    
 
 

 

Monthl Sal Increase Descri tion

PM 99,499.92

Oflice of the

   
 

 

 

 

 

 

IF NEW HIRE: Requisition Date of Vacancy H, - 2015

IF SEPARATION: Transfer to Org Leave of Absence FROM TO 
Separation Dates: Last Day Worked HRS MIN Last Day on Payroll HRS 
Leave Paid Annual Sick Leave Balance Annual Sick _West Virginia
CURRENT BUDGET INFORMATION Depam-nem of Revenue
POS 57 Title Investiqator Effective Date Current HRS MIN 

Pay Periods 24 Hourly Rate, Base Rate?

DOP EEO-4 Code Class Code Pay Grade_ Step Supervisor FTE 

 

        
  
  

  
   
 

    

ACCOUNT INFORMATION

 

   

  
        

    
 

   
   

  
 
 

I Fund FY Activity Unit Code Base Annual Salary Annual TOTAL
 Increment 
 mo 

 

   

 

TOTAL
PROPOSED 

*irir

 

 

I. $45,000-0

PER PAY PERIOD 4,145.83

$45,000.00

 

 

 

 

 

 

 

 

 

 

 
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POS 57 Title Deputy Chief of Staff I'Effective Date September 8. 2015 HRS MIN
Pay Periods 24. Hourly Rate I Base Rate 8,291.66
DOP Pay Grade__ Step Supervisor FTE
ACCOUNT INFORMATION
Fund FY Org Activity Unit Code FTE Base Annual Salary Annual TOTAL
Increment
"150 2?15 1500 001 '5 $49,749.96 $0.00 $49,749.$49,749.96 $49,749.96
 kirk 

STATE BUDGET OFFICE USE ONLY Division Signature
Pending 9 DatelBy 9? EI  I DATE I 3
Approved 9 Date/By '19- aure-Area Office 
DIVISION OF PERSONNEL USE ONLY  I it}, -. I I5 
9 Approved 9 Disapproved 9 Noted DATE ERNUB  .-Signature 5H- arr-9w Jr?. .4414: (agate-'LDATE 
STATE BUDGET OFFICE 3/
1 WHITE-STATE BUDGET OFFICE ORIGINATOR :32 DATE

 

2 GREEN - AGENCY PAYROLL OFFICE 5 GOLDENROD

3 CANARY - DIVISION OF PERSONNEL WV-11 (Rev. 

IWVIIFORMII