LD-T002 DOCENTES O NO DOCENTES A 12 MESES-rev 15-AGO-2023 Logo UPR-INGLES NO FORMULAS.xls

	A	B	E	F	G	H	I	J	K	L	M	N	O	P	Q	R	S	T	U	W	X	Z	AB	AC	AE
1	UNIVERSITY OF PUERTO RICO
2									UNIT:
3	HUMAN RESOURCE OFFICE
4	NOTIFICATION OF CHANGE AND PERSONNEL TRANSACTION WITH SALARY DISTRIBUTION
5	12 MONTHS APPOINTMENT FORM
6
7	Fiscal Year:						Email:														Reference Number:
8	1. Name:																				2. Employee Number:
9	3. Transaction:																				5. Academic Qualifications
10	4. Purpose:
11	6. Work Day:		Full:					Partial:			Hours per week:
12	7. Effetive Date:		Month	Day	Year							8. Termination Date:					Month	Day	Year
13	9. AEELA			10. Retire		DCP		N/A	11. Health Insurance					12. Type of Visa					13. I-9 Effectiveness (mm/dd/yyyy)					14. Exempt
14		Yes	No							Yes			No					N/A						Non Exempt
15	EMPLOYMENT DATA
16								CURRENT											AFTER THE CHANGE
17	15. Pay Scale (category, level, five year salary increase "quinquenios")
18	16. Faculty, Department, Deanship, Office
19	17. Organizacion's Default Account
20	18. Tittle/Rank
21	19. Appointment Type
22	20. Position Number
23	21. Service Type
24	22. Payment Element
25	23. Monthly Payment or Period Payment												Monthly		$0.00		Bimonthly					Monthly	$0.00		Bimonthly
26	24. Current Annual Institutional Base Salary (if applies)												OK						25. Time and Effort Report Required					Yes	No
27	26. Off-Scale Salary
28	Athorized Amount Above Pay Scale					$ 50,500.00										Athorized Salary Increase
29	Academic Preparation Increase															Five Year Salary Increase
30
31	27. SALARY DISTRIBUTION BY ACCOUNTS
32	Account Number						Principal Function and Project's Name				Date of Effectiveness of the Account						Level of Effort	Monthly Salary (12 month)		Total Salary of the Period of the Transaction		Hourly Salary	Certification of Funds
33											month/day/year
34											Start			End
35	27 a. UNIVERSITY FUNDS
36
37
38
39
40
41
42														Sub Total:			0.00%	$ -		$ -		$ -
43	27 b. EXTERNAL FUNDS
44
45
46
47
48
49
50
51
52
53
54	Sub Total:																0.00%	$ -		$ -		$ -
55	27 c. COST SHARING OR MATCHING FUNDS
56
57
58
59
60
61
62
63
64
65	Sub Total:																0.00%	$ -		$ -		$ -
66	28. TRANSACTION FOR ADMINISTRATIVE DUTIES OR ADJUSTMENT FOR FACULTY BASE SALARY
67
68
69
70
71
72
73	Sub Total:																0.00%	$ -		$ -		$ -
74	Total Institutional Base Salary																0.00%	$ -		$ -		$ -
75	29. PAYMENTS FOR OTHER WORK NOT INCLUDED IN THE INSTITUTIONAL BASE SALARY (Additional Compensations, One-Time Payments, Incentives that doesn't involves time and effort)
76
77
78
79
80
81
82	TOTAL :																0.00%	$ -		$ -		$ -
83	30. SIGNATURES AND DATES
84
85
86		Employee										Date					Budget Office Director or Auth. Representative								Date
87
88
89		Inmediate Supervisor										Date					Finance Office Director or Auth. Representative								Date
90
91
92		Home Department										Date					Principal Investigator or Poject Director								Date
93
94
95		Dean or Office Director										Date					Principal Investigator or Poject Director								Date
96
97
98		Human Resources Director or Auth. Representative										Date					Appointing Authority or Authorized Representative								Date
99
100	31. COMMENTS: