Employee Change Form - Sebo Training

Last Updated on May 23, 2022

Name of Person Submitting Form

Employee Name

Employee whose status, compensation, benefits or other HR related item will be changed.

Date Change Should Take Effect

If this is a pay change, please include the date that the new pay rate should start. If this is a new employee, please indicate the new employee's planned start date (for onboarding preparation purposes). If this is a request for Maternity/Paternity leave, please indicate your tentative idea of when the leave would start (does not need to be final, just a guess). Same for other benefits such as VASA etc.

New Hire Employees

Employee Tentative Start Date

Does not need to be final. If a start date needs to be determined still, you may indicate that here, or include any other notes.

Employee Starting Pay

Compensation Changes - Current Employees

Status Change

Full Time, Part Time, Hourly, Salary etc. Any status changes note here.

New Compensation

New hourly rate, or annual salary

Benefits Changes

Benefit Request

401k - American Funds

Dental Insurance

Maternity/Paternity Leave

Vasa Membership

Race Registration Reimbursement

Other

Which benefit from Sebo would you like to add, remove or modify?

Notes About Request

Describe what you would like changed (add, modify, remove or request a benefit).

Additional Notes

Any Departments Need to be Notified or Special Actions Taken?

Any Other Notes Related to This Change?

Please describe in detail anything that we would need to know to make sure this change takes place accurately.