Furlough Clearance Template



Use template to check for furloughees for Civil or Non-Civil Service positions.Email template to: ra-pancs@state.pa.us Type: FORMCHECKBOX Civil ServiceIs position blocked? FORMCHECKBOX Yes FORMCHECKBOX Non-Civil Service FORMCHECKBOX Non-Civil Service Pay Scale Group 6 and above clearance FORMCHECKBOX ConfidentialAgency Name: FORMTEXT ?????Facility Name: FORMTEXT ?????Bureau Name: FORMTEXT ?????County: FORMTEXT ?????Job Name: FORMTEXT ?????Job Code: FORMTEXT ?????Pay Scale Group: FORMTEXT ?????Bargaining Unit: FORMTEXT ?????Time/Work Code: FORMCHECKBOX Permanent Full-Time FORMCHECKBOX Permanent Part-Time FORMCHECKBOX Temporary Full-Time FORMCHECKBOX Temporary Part-Time FORMCHECKBOX per diemNumber of vacancies FORMTEXT ?????Comments: FORMTEXT ?????For BSE only:No furloughees__________Furloughee, contact BSE for instruction__________Date:__________ BUREAU OF STATE EMPLOYMENT110 FINANCE BUILDINGHARRISBURGPA 17120717-787-5703 ................
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