Personnel Action Form: Company Logo Here

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COMPANY LOGO HERE

PERSONNEL ACTION FORM


EMPLOYEE NAME
STAFF NUMBER
HIRE DATE
TYPE OF ACTION Regularization Salary Increase
Promotion Change in Job Title
Transfer Others:
EFFECTIVE DATE OF ACTION

FROM TO
POSITION TITLE
DEPARTMENT
TEAM
JOB CLASS
IMMEDIATE SUPERVISOR
WORK LOCATION
MONTHLY BASE SALARY
MONTHLY ALLOWANCES
TRANSPORTATION
COMMUNICATION
ATTENDANCE
OTHERS
LEAVES
VACATION LEAVE
SICK LEAVE
BEREAVEMENT
MARRIAGE LEAVE
SOLO PARENT
OTHERS:
HMO (MEDICAL INSURANCE) BASED ON COVERAGE
LIFE INSURANCE BASED ON COVERAGE
Note: Transportation and Communication Allowance are provided based on the nature of job. This can be changed or discontinued on
the sole prerogative of the company.

PREPARED BY: APPROVED BY: CONFORME

[FULL NAME] [FULL NAME] EMPLOYEE'S NAME


Position Position The foregoing change(s) was/were discussed and
explained to me in a language and/or dialect that I
know and undertandand hereincertify that I have fully
read and understoodthe details of this document and I
hereby freely and voluntarily, without force or
intimidation, accept, agree, and consent to such
change(s) as indicated above as shown by my
foregoing signature.
Date: Date: Date:

COMPANY ADDRESS HERE

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