Polk County

POLK COUNTY BOARD OF COUNTY COMMISSIONERS APPLICANT REFERRAL LETTER TO: JOB TITLE: NAME: meets the minimum qualifications for POSITION: DATE OF APPOINTMENT: TIME: After interviewing all applicants for this position and a selection has been made, circle either “A” or “B” and return form along with a Personnel Action For

BoCC Badge Request Form

Cell phone and air card order form.

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Communications Service Request

COMMUNITY BULLETIN BOARD REQUEST POLK COUNTY GOVERNMENT ACCESS TV Please fill out the form below to request a Community Bulletin Board announcement. Requests should be received two (2) weeks in advance of the desired start date of airing. All requests will be handled on a first-come first-served basis. Your message sho

Emergency Management Pager Request Form

Emergency Management Pager Turn-In Form

Employee Action Form

Performance Evaluation Report = Date: EMPLOYEE PERFORMANCE EVALUATION REPORT Name: P/R#: Employee #: Job Class: Dept: Div: Evaluation Period: From To Rating Standards Performance frequently does not meet job expectations, improvement is necessary to avoid disciplinary action. Substantial improvement is ne

EMPLOYEE PRE-EVALUATION WORK SHEET POLK COUNTY BOCC EMPLOYEE NAME: DATE: DEPARTMENT: DIVISION: IMMEDIATE SUPERVISOR: Dear : It is time for you to re ceive a fo rmal p erformance e valua tion report. I view this process as an extremely valuable opportunity for you and I ( as your supervisor ) to have a meaningful two-wa

Polk County Board of County Commissioners Employee Requisition Form

Page 1 of 4 Equal Opportunity Employer Taking Pride In Equality and Diversity KANDIS BAKER-BUFORD 330 West Church Street Equal Opportunity Administrator Post Office Box 9005 DrawerCA05 ALEJANDRO VELAZQUEZ Bartow , FL 33831 Equal Opportunity Specialist Telephone (863) 534-5901 Fax (863) 534-7626 Board of County Commissi

Page 1 EXIT INTERVIEW EVALUATION FORM Termination Date: _________________________ Date of Hire: ________________________ Name_____________________________________ Position_____________________________ Supervisor________________________________ Division____________________________ Please take a few minutes to answer the

Equal Opportunity Employer Human Resources Division Percy L. Harden Human Resources Director www.polk-county.net 330 West Church Street Drawer CA03 PO Box 9005 Bartow, FL 33831 T: (863)534-6030 F: (863) 534-6534 Board of County Commissioners TO: Employee Leaving County Employment FROM: Charles J. Fairchild, Employee Re

Polk County Board of County Commissioners Exit Interview Process ______________________________________________________________________ The Polk County Board of County Commissioners considers its employees to be its most valuable resource. As a result, the County is committed to identifying and implementing strategies

TO: All BoCC Department and Division Directors FROM: Charles Fairchild, Employee Relations Manager SUBJECT: Family Medical Leave Act (FMLA) DIVISION DIRECTORS ARE RESPONSIBLE FOR DISSEMINATING THIS TO ALL OF YOUR SUPERVISORY AND PAYROLL REPORTING PERSONNEL. Under the FMLA a supervisor may be held "PERSONALLY" liable fo

TO: PERSONNEL (EMPLOYMENT SERVICES) FROM: _____________________________________________ ___________________________________________ (Department/Division Director) (Signature) SUBJECT: JUSTIFICATION TO FILL POSITION AND SPECIFIC REQUIREMENTS DATE:__________________________ INTERVIEWING SUPERVISOR:_______________________

Imperial POLK COUNTY Board of County Commissioners Bartow, FL Date__________________________ TO: POLK COUNTY, Board of County Commissioners FROM: _________________________________________ Department:__________________________ EMP ID#: ________________________________ SUBJECT: REQUEST OF LEAVE OF ABSENCE I, ____________

I.T. MAINFRAME USER ENROLLMENT FORM DATE: _________ DEPT/DIV/AGENCY:____________________________ USER NAME: __________________________________ USER SIGNATURE: _____________________________ USER TEL.#:____________________________________ REQ. SUPV. NAME: _____________________________ REQ. SUPV. SIGNATURE: ______________

Oracle Authorization Request Form

OUTSIDE EMPLOYMENT TO: Supervisor or Division Director Job Title I request permission to engage in part-time, outside employment other than my full-time job with Polk County. This employment will in no way conflict or create a problem with my performance in my regular County position. I understand and agree to all the

Performance Improvement Plan The Polk County Board of County Commissioners expects all employees to act in a professional, mature, safe, and responsible manner at all times. The purpose of the Performance Improvement Plan is to provide a way to identify areas of concern and to provide steps for effective corrective act

REQUEST FOR RECLASSIFICATION OF A POSITION

DATE: _______________________ REQUEST FOR LEAVE DEPT: ________________________________ DIVISION: ____________________________ NAME___________________________________________________________________________________________________________________ (Last) (First) (Middle Initial) (Employee Number) TYPE OF LEAVE LEAVE TIME

Reset Form Emp No.

SICK LEAVE SHARING FORM THE HOURS DONATED ARE TO BE USED FOR THE EMPLOYEE ONLY -NOT EMPLOYEES FAMILY MEMBER (S). DATE: ___________________________ DONATING EMPLOYEE PAYROLL NO.______ PAYROLL NAME_________________________________ NAME (PRINT)______________________________________________ ___________ LAST FIRST MI ID NO.

POLK COUNTY BOARD OF COUNTY COMMISSIONERS TERMINATION OF SERVICE EVALUATION Employees Name _______________________________________________ Date________________ Department____________________________________ Job Title_____________________________ Last Date Worked_______________ Hire Date_______________ Reason for Separa

Emp No ________ TERMINATION INFORMATION SHEET Name ___________________________ Date ___________________ P/R# _________ Division ______________________________Last Day Worked____________________ Instructions for final paycheck: ( ) Send to employees division ( ) Pick up in Personnel Office ( ) Mail to the following addr

BOCC EMPLOYEE: This form will be used upon termination with the Board of Commissioners. Your final pay will be processed with a check and will not be sent Direct Deposit. AUTHORIZATION AGREEMENT FOR DIRECT DEPOSIT WITHDRAWAL FORM POLK COUNTY BOARD OF COUNTY COMMISSIONERS I hereby authorize POLK COUNTY BOARD OF COUNTY C

THREE MONTH EVALUATION EMPLOYEE: DATE: JOB TITLE/CLASSIFICATION: DIVISION /DEPARTMENT: EFFECTIVE DATE: Evaluation should be based on the employees proven abilities in the new position only. Place a check in the applicable boxes noted below. NEEDS IMPROVEMENT SATISFACTORY ABOVE SATISFACTORY EXCEPTIONAL WORK HABITS: QUAL

COMPLETION OF TRIAL PERIOD EVALUATION EMPLOYEE: DATE: JOB TITLE/CLASSIFICATION: DIVISION /DEPARTMENT: EFFECTIVE DATE OF PROMOTION /TRANSFER: This form is to be used only upon completion of a promotional /lateral transfer trial period, not to exceed six (6) months from the date of promotion /transfer. Evaluation should

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Vacation Request - 40 Hours

Emp No P1046 Rev. 10/01 Reset

Monthly Cost Calls Placed From Within Florida Calls Placed From Outside Florida County Base Plan Included Features & Cost (per minute) (per minute) Local Digital Choice Per Minute Rate 6 39 Basic Voice Mail See Notes NA NA Call Waiting See Notes NA NA Call Forwarding See Notes NA NA 411 Call Connect See Notes $1.25 ea

VOLUNTARY SEPARATION Employees Name______________________________ Date of Notice__________ Effective Date_____________ Position____________________________________ Department____________________________ Division_______________________ This is my official notice of resignation. My reason for resigning is: (attach letter

Emp NoP1042 Reset

Volunteer Daily Time Log Name: ____________________________________________________ Phone #: _________________ Address: ____________________________________________________________________________ ___________________________________________________________________________ E-Mail Address: _______________________________

Form W-4 (2009) Purpose. Complete Form W-4 so that your employer can withhold the correct federal income tax from your pay. Consider completing a new Form W-4 each year and when your personal or financial situation changes. Head of household. Generally, you may claim head of household filing status on your tax return o

Instructions What Is the EIC? You may have only one Form W-5 in effect at one time. If you and your spouse are both employed, you should file separate Forms W-5. Give the bottom part to your employer; keep the top part for your records. Detach here W-5 Form This certificate expires on December 31, 2009. Your social