PAYROLL STATUS CHANGE FORM - urbandaleorg 2026

1. Click ‘Get Form’ to open the PAYROLL STATUS CHANGE FORM in the editor.
2. Begin by entering your Employee Name at the top of the form. Ensure that this is accurate as it identifies you in the payroll system.
3. Select your employment status by checking one of the options: FT (Full-Time), PPT (Part-Time), or PT (Part-Time).
4. Fill in your Position and Department, followed by the Effective Date of the change.
5. In the REASON FOR CHANGE section, select one or more reasons for your status change, such as Hired, Promotion, or Transfer. If applicable, provide additional comments in the designated area.
6. If you are separating from employment, indicate whether it is Voluntary or Involuntary and provide your Last Day Worked.
7. List any City Property being returned, such as keys or technology, and confirm if you are Eligible for Re-Hire.
8. Finally, ensure that both Department Authorization and HR Approval sections are completed with dates and initials before printing and returning to Human Resources.

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