Action Request Form
Human Resources
The University Corporation
Action and General Info
Waiver of Recruitment
Emergency Hire FT
Emergency Hire PT
Emergency Hire Interim
Changes
Named In Grant
Graduate Research Assistant
Scholar
Other- Compensation or change
to appointment
Complete Waiver of Recruitment section below
Complete Change Section below
PAYROLL INFORMATION
Department Name:
Account:
Fund:
Department:
* TUC, Research & Sponsored Projects (Print):
New Position?
Yes
Project:
Signature:
No
Date:
Job Title:
Name of Hire:
Reports to:
Reason for Appointment:
Brief Job Description or Include Attachment:
Recruitment
Effective Date:
Time Base:
End Date:
Full-time (30 hours+) Full time Benefits: Medical, dental, vision , Vacation/Sick
Part-time -
# of hours
Part time Benefits: Vacation/Sick Benefits?
Part Time Intermittent – No Benefits
Salary or Hourly Rate :
License / Certification:
Pay Type:
Yes
No
Fingerprint:
Yes
No
Give average number of hours/week:
Salary
Yes
Effective Date
Hourly
No
Email:
Yes
No
End Date
Change To: (if applicable)
(if applicable)
Extend Temporary Appointment
Additional/Concurrent
Assignment
Reassignment
Changes
Time Base Change - Temporary
Time Base Change – Ongoing
Dept:
Time Base:
Compensation Review
Time Base:
Other –
OHR Approval: _______________ Date ________________
CONTACT INFORMATION
Name:
SIGNATURES/APPROVALS
Name of Director, Research & Sponsored Programs (If Applicable) PRINT
Name of Supervisor PRINT
Auxiliary Human Resources (NAME / TITLE) PRINT
TUC AUX (Rev. 04/2016)
Job Title:
Reports to Name:
Explain:
CSU Comparable: _______________________________
Extension:
Signature:
Signature:
Signature:
Date:
EXT:
Date:
EXT:
Date:
EXT:
Appointment Type
Emergency Hire FT
Types of Temporary Hires
Non-Exempt Minimum Wage: $10.00 per hour
Exempt Minimum Wage: $3,466.67 per month
Do they need to
Pay
Hours
Benefits
be enrolled as a
Requirement
CSUN student?
FT >30
No
Based on
Full time – 30+ eligible for
position and
hours
benefits
level
Expiration
Maximum
3 months
6 months
Emergency Hire PT
No
Based on
position and
level
Named in Grant
No
Based on
position and
level
Graduate Research
Assistant
Yes. Must be
enrolled as a
current student
$10.00 to
$21.00 based
on type of
work
Research Assistant
Scholar
No
No
$10.00 to
$21.00 based
on type of
work
Based on
position and
level
Part time- Less
than 30 hours
Full time (30+)
or Part time
Full time (30+)
or Part time
Full time (30+)
or Part time
Full time (30+)
or Part time
No benefits
Can be
renewed once
FT >30
eligible for
benefits
PT < 30 not
eligible for
benefits
FT >30
eligible for
benefits
PT < 30 not
eligible for
benefits
FT >30
eligible for
benefits
PT < 30 not
eligible for
benefits
FT >30
eligible for
benefits
PT < 30 not
eligible for
benefits
Date used is
Grant
expiration
No expiration
6 months
Can be
renewed once
School in
session- max 20
hours a week
Student Assistant –
No Action Request
is needed
Yes. Must be
enrolled as a
current student
Licensing Liaison
No
TUC AUX (Rev. 04/2016)
$10.00 to
$17.26 based
on type of
work
School not in
session- can
work 40 hours
a week for a
maximum of 3
months a year.
No benefits
No Expiration
$16.00 or
$33.00
Hired per event
No benefits
6 months
TUC AUX (Rev. 04/2016)