Request For Transfer
Tennessee Department of Safety
Request For Voluntary Transfer
|PLEASE USE LEGAL NAME |
|Last Name: | |First Name: | |MI: | |
| | | | |
|Rank/Title: | |Edison Empl ID #: | |SSN: | |
|Current Station/County |
|District #: | |County #: | |Date assigned to current Division/County: | |
|01 |
|District/Division Name |County Name | |Reason: (If additional space is needed, use additional sheet) |
|1st Choice: | | | | | |
|2nd Choice: | | | | | |
|3rd Choice: | | | | | |
|Employee | |Date: | |
|Signature: | | | |
|For Administrative Use Only |
| | |Agree? | | |
|Immediate Supervisor (Sgt) Signature: | | Yes | No |Date: | |
|District Supervisor (Lt.) Signature: | | Yes | No |Date: | |
|Asst. Director (Capt.) Signature: | | Yes | No |Date: | |
|Director (Lt. Col.) Signature: | | Yes | No |Date: | |
|If you marked NO, please write a separate memo stating why, attach this request to your memo and continue processing through the chain of command. Transfers will |
|remain on file in Division Head’s office until action is taken. |
|Deputy Comm. (Col.) Signature: | | |Approved |Date: | |
|Commissioner Signature: | | |Authorized |Date: | |
|Transfer Effective: | | | | | |
|HR Director: | |Date: | |
|For Human Resources Use Only |
|From |To |
|Pos#: | |Pos#: | |
|Seq#: | |Seq#: | |
|Wk Co: | |Union Code: | |Wk Co: | |Union Code: | |
|Troop/ Station:| |Pay Group: | |Troop/ | |Pay Group: | |
| | | | |Station: | | | |
|Dept ID: | |Dept ID: | |
SF-0117 (Rev. 01/10) RDA –S1280
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