Bannock County Courthouse in Pocatello Idaho



REV 1/19

BANNOCK COUNTY

SALARY RATE APPROVAL FORM

| | | | |

|EMPLOYEE NAME | |NUMBER | |

|(Must match SS card) | |(assigned by payroll) | |

| | | | |

|DEPARTMENT | |ACCOUNT NUMBER | |

| | | | |

|JOB TITLE | |PAY GRADE | |

| | | | |

|PROPOSED START DATE | |OFFICIAL START DATE | |

| |

|NOTICE TO DEPARTMENT HEADS/ELECTED OFFICIALS : |

|This form should be completed and approved by Board of Bannock County Commissioners and the employee orientation completed before a new employee |

|has actual hours worked for Bannock County. |

|Please allow for a minimum of two weeks for processing. |

| |STATUS/ CLASSIFICATION FOR BENEFIT PURPOSES: |

| |Elected Official | |YES | |NO | | |

| |Exempt Employee | |YES | |NO | | |

| |Full-time Regular Employee | |YES | |NO |40 Hours per week |

| |Temporary Employee | |YES | |NO |120 Hours or less per calendar month for less than 5 months |

| | |

Nonexempt Employee Exempt Employee

| | | | | | |

|PRESENT SALARY: |Hourly | | |Biweekly | |

| | | | | | |

|REQUESTED SALARY: |Hourly | | |Biweekly | |

| | |

|If a replacement, for whom : | |

| | |

|Reason for change/comments: | |

| | |

| |

| | | | | |

|Prepared By : | |Date Signed : | | |

| |Elected Official / Department Head | |

| | |

SEND TO LEGAL COUNSEL/HR

|EMPLOYEE NAME : | |TITLE : | |

|LAW ENFORCEMENT BCKGRND/TESTING BY: | |DATE: | | |

| | | | | |

|Approved for Hire: |Yes ____ No _____ N/A _____ | | | |

|JUDICIAL REVIEW BY: | |DATE: | | |

| | | | | |

|Approved for Hire: |Yes ____ No _____ N/A _____ | | | |

| | | | | |

|LEGAL REVIEW BY: | |DATE: | | |

|Comments : | | |

| | | |

|HR REVIEW BY: | |DATE: | | |

| | | | | |

|Comments : | | | | |

| | | | | |

|**TO BE USED FOR AUDITING PURPOSES ONLY** |

|PAYROLL AUDIT BY : | | | |DATE: | | |

| | | | | | | |

| Currently Budgeted |$ | |

|Projected to be Used |$ |Does include pay out of vacation/sick/comp hours. |

|Difference (+ or -) |$ | | |

|Comments : | | |

| | | |

| | | | | | |

|BUDGET AUDIT BY : | | |DATE: | | |

| New annual salary | | |

| |$ |Benefits are not included in amount. |

| Old annual salary | | |

| |$ |Benefits are not included in amount. |

| Difference (+ or -) | | |

| |$ |( % of Change ) |

|Comments : | | |

| | | |

|Will this impact next year’s budget? | | |

| |YES NO If yes, how much? $_____________ | |

| | | |

|Comments: | | |

ATTN COMMISSION: PLEASE DO NOT SIGN IF REVIEW AND AUDIT HAVE NOT BEEN COMPLETED

BOARD OF BANNOCK COUNTY COMMISSIONERS:

Steve Brown, Chairman

Terrel N Tovey, Member

Ernie Moser, Member

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