U of M Ann Arbor Student Temporary Appointment Change Form | U of M Ann Arbor Student Temporary Appointment Change Form TO BE COMPLETED BY DEPARTMENT AND MAILED TO HRRIS at 4073 Wolverine Tower, Campus Zip 1281 PART 1. Date prepared: Is this a Work Study approved position? Yes No Changing the effective date of the Work Study position to: Name (Last, First, MI): UMID: PART 2. APPOINTMENT CHANGE INFORMATION (do not complete this section for terminations) Empl Rcd# * Effective Date* Dept ID* Job Code* Job Code Title* Job Posting # Hourly Rate* End Date ShortCode* % Distrb** * These fields are required. List the data as it should appear after the change. NOT as it exists today. The data may be the same as it exists today, if you are only processing a change to Work Study effective date. ** The % Distrb must add up to 100 per Empl Rcd#. PART 3. TERMINATION INFORMATION (if "No Rehire", then mail form to your central office HR representative) Empl Rcd# (required) Dept ID (required) Job Code (required) First Day NOT Worked (required) Reason (choose one): Another Position Elsewhere Discharged (must explain in Remarks) Returned to School Schooling Completed Other (must explain in Remarks) Relocation Temp Appointment Completed Quit Without Notice Recommended for Rehire (choose one): Yes No Rehire (must explain in Remarks or attach dept. letter) Yes, restricted (must explain in Remarks) Paycheck Distribution Point (choose one): UM Dearborn Cashier 0094 UM Flint Cashier 0092 Direct Deposit (On-Line Self Service) Payroll Office 0026 Hong Kong 0002 . Mailing Address 9999 Other Contact Person: Supervisor: Department: Supervisor UMID: Contact Campus Address: Campus Zip: Campus Phone: (734) Remarks: Authorized Signature and Date: _ Form 37002A, page 1 of 2, 1st Edition 7/23/2007 Form available at: Instructions for "U of M Ann Arbor Student Temporary Appointment Change Form" General Use: This form is used to process changes to