HR Change Form

Instructions
▪ Complete this form for non-MSS eligible transactions after all approvals have been secured and
the change is ready for data entry
▪ Fill out the General Information section (required*) and other sections applicable to the change
▪ Send signed form in PDF format to local HR Support Services

HR Support Services Contact List

General Information*
Employee First Name: Hemanta Requester First Name: Padmnabh
Employee Last Name: Choudhury Requester Last Name: Joglekar
Employee ID: 45069 Effective Date of Change: 1-Jan-23

Termination - Involuntary or HR Only

Reason*:  Eligible for Rehire*: 
Pay Thru Date / Last Day Last Day Worked (if
of Employment*: different):
Visa Holder: 
Notes:

Pay Rate Change - Adjustment

Reason: Promotion to Fill Open Position  Currency: INR - Indian Rupee 
Requisiton #: 22010684 Current Comp Rate: 1,423,871.00
Hourly or Salary: Salary  New Comp Rate: 1,700,000.00
Standard Hours: 40.00 Bi-weekly Rate (US):
Full/Part Time: Full-Time  Percent Change: 19.4%
Job Code: 01047 Pay Group (US): 
Job Code Description: Project Data Manager
Country Transfers only:
Current Country: Continuous Service: Yes 
New Country: New Supervisor Name: Saranya Kalva
New Supervisor HRID:
Notes: Hemanta was interviewed and is selected against the PDM position through IJP process.

Pay Rate Change - Step Progression / In-Band Promotion

Reason:  Current Comp Rate:
Currency:  New Comp Rate:
Percent Change:
Notes:

Retention Bonus
Currency:  EBS BU Code:
Bonus Amount: Department Code:
Payout Date: Department Description:
Clawback Period:
Notes:

Initiate Leave of Absence Extend LOA or Return from LOA

Leave Start Date: Extended LOA Date:
Expected Return Date: Return From Leave Date:
Leave Action*: 
Leave Reason: 
Notes:

Allowance & Deduction

Reason:  Currency: 
Frequency:  Amount:
Notes:

Other Changes / Notes

Change Hire Date:
Convert to Perm:
Other Changes / Notes:

Deployment Solutions only - Transfers

Project Change Adjusment for Sales IQ
New Project Name: New Supervisor Name:
New Project Code (if
available): New Supervisor HRID:
New Geo ID: Business Title:
New Geo Name: Operations Mgr. Name:
Notes:

Requester Signature: