UCSD Medical Center>Career Center

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Career Center		For Job Seekers \| For Employees \| For Nurses

Personnel Action Request (PAR)

Employee Name (Last, First, MI)	Employee #	Employee Ext.	Employee Mail Code	Department Contact Name/Mail Code/Phone

Merit Increase *	Separation (Type Code)	Leave of Absence (Type Code)	Promotion (1)
Demotion (1)	Lateral Transfer (1)	Additional Employment (1)	Change in Percent (2)
Appointment Renewal/Extension	Funding Change	Stipend (3)	Range Adjustment
Reclass/Downward	Reclass/Upward	Reclass/Lateral	Casual/Per Diem to Career
ESI/Equity Increase (3)	Other Payrate Change	Casual Increase	Other
Data Correction	By-Agreement Payment (3)	Certification Pay

Documents/Attachments Required:
(1) Employment Requistion, Signed Job Description, and Application or Resume
(2) Voluntary Reduction In Time Form (Voluntary reductions only)
(3) Letter to support the increase (Can be sent via SYSM to AMR1 or e-mail to rygonzalez@ucsd.edu)
(4) Signed Casual/Per Diem to Career Letter and documents listed in Item (1)
* List the last evaluation date and rating in the "Explanation of Change/Comments Section

Department Name	Home Department Code	Title Code	Title	Begin Date	End Date	% Time	F/V	Hourly Rate

Index Name		Index/Fund/Sub	Pay Type (I.E. Reg Pay)	Begin Date	End Date	% Time	F/V	Hourly Rate

Explanation of Change/Comments:

Approvals: (DEPARTMENTAL AUTHORITY)

Date:

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