Employee’s Signature Date. ACKNOWLEDGEMENT I have read the above Designation of Authorized Representative and I hereby accept and agree to act as Authorized Representative.
Employee’s Signature Date. The presence of the employee's signature shall indicate that the evaluation form has been reviewed by the employee. Signature does not necessarily imply agreement with the evaluation. Statement by evaluatee attached. The evaluatee always has the right to prepare a written response to any formal evaluation. The response shall be attached at the time the evaluation is submitted to the Personnel Office.
Employee’s Signature Date. BENEFITS ADMINISTRATOR DATE *The amounts you choose will be reviewed by the Benefits Administrator prior to the execution of Agreement. Original/Employee File Copy/Reduction Agreement Book Copy/Premium Payment Folder
Employee’s Signature Date. SUPERVISOR'S APPROVAL DATE: / / TOTAL HOURS FOR PAYROLL USE ONLY: UNITS HRLY RATE TOTAL DATE ENTERED / / DIFF BY Note: This timesheet is due in Payroll the first working day after the 15th. For information, contact payroll EXT 619/610 or xxxxxxx@xxxxxxxx.x00.xx.xx Page 82 ROUTE: WHITE‐Payroll YELLOW‐Employee Revised: 1/2019 APPENDIX C (page 2 of 2) NOTE: This time sheet is due in the Payroll Office the first working day after the 15th of the month. For information, email the Payroll Office at: xxxxxxx@xxxxxxxx.x00.xx.xx PIEDMONT UNIFIED SCHOOL DISTRICT OVERTIME REPORT (Classified Employees) Employee Name (please print) EID # Requesting (check one): Comp Time Off; Pay by Warrant Date Overtime Total O.T. Hours Worked Nature of Work Performed Account Code to be Charged (If Comp Time, no account code needed)
Employee’s Signature Date. The presence of the employee's signature shall indicate that the evaluation form has been reviewed by the employee. Signature does not necessarily imply agreement with the evaluation. □ Statement by evaluatee attached. The evaluatee always has the right to prepare a written response to any formal evaluation. The response shall be attached to the evaluation submitted to the Personnel Office. pc: Employee Evaluator/Supervisor Personnel File Association President □ Yes □ No APPFORM APPENDIX III – SECRETARIAL POSITION AND DAYS WORKED Secretarial Position Annual Days worked Accounting Secretary 248 Business Secretary (part time) 90 Bilingual/ELL/Title One Secretary 198 Community Ed Accounting Secretary 248 Community Ed Secretary 248 Director of Athletics Secretary 248 Director of Operations Secretary 248 Director of Special Services Secretary 248 Elementary Building Secretary (part time) 201 Elementary Principal Secretary 204 ESC Receptionist (part time) 218 Food Service Secretary 214 High School Accounts Secretary 248 High School Assistant Principal Secretary 210 High School Building Secretary 204 High School Building Secretary (part time) 204 High School Counseling Secretary 209 High School Principal Secretary 224 Human Resources Secretary Classification C 248 Human Resources Secretary (part time) Classification B 129 Information Systems Secretary 248 LA/SS and Math/Science Secretary 198 Maintenance/Facilities Secretary 248 Middle School Building Secretary 214 Middle School Counseling Secretary (part time) 195 Middle School Principal Secretary 215 Outdoor Education Secretary (part time) 201 Payroll Secretary 248 Preschool Secretary 248 Prime Time Care Billing Secretary 248 Prime Time Care Secretary (part time) 248 Purchasing Secretary 248 Special Services Medicaid Secretary 215 Special Services Secretary 215 Student Services Enrollment Secretary 248 Student Services Secretary 248 Student Services Secretary (part time) 198 Substitute Caller Secretary 248 Supervisor of Food Service Secretary 248 Teacher Certification / Records Secretary 248
Employee’s Signature Date. Employee’s Supervisor Signature Date
Employee’s Signature Date. Rev.10/2021 FOR INTERNAL USE ONLY: ADP- Employee Benefits File
Employee’s Signature Date. This page must be signed by the covered employee and retained by the employer.
Employee’s Signature Date. The employee should submit this completed form to the Department of Human Resources.
Employee’s Signature Date. Professional holding a doctoral or masters degree from an accredited college or university Other (Specify)
