Intermittent Work Means the Work Hours Are Irregular and Not Continuous

Agency Name: / Personnel Area Number: / Date of Request:
New Position

Extension of previously authorized exemption[Attach most recent approval]
TYPE OF REQUEST:
Director-Approved [4.1(d)1]
Work is seasonal, temporary (12 months or less), intermittent or part-time / Commission-Approved [4.1(d)2]
All other requests for exemption of positions from the classified service

Seasonal means the job is needed for short-term specific instances such as Tax Processors during Tax Filing Season, Ticket Takers at Athletic Events, or Security Guards who work weekends or events only (usually 5 months or less).

Intermittent work means the work hours are irregular and not continuous.

Part-time means a regular work schedule consisting of fewer than 40 hours per week.

NEW POSITION INFORMATION:
Job Title: / Job Code (if known): / Working Job Title (if used):
Reports To (Job Title)? / Pay Range? / Number of Positions Requested: / Length of Time Position(s)
Needed:
Proposed Effective Date: / Proposed End Date: / Anticipated Number of Work Hours Per Week:
EXTENSION INFORMATION:
Position Number(s): / Current Expiration Date: / Number of Positions Requested:
Job Title: / Job Code (if known): / Working Job Title (if used):
Employee Name: / Employee ID:
Pay Range? / Length of Time Position(s) Needed: / Number of Hours Worked (weekly per FY): / Anticipated Number of Hours per week on this extension:

If requesting an extension, what was the first date that authority was granted and list each subsequent extension date.

Please explain why a classified appointment is not appropriate for this position. (What makes these duties distinctively different from similar duties in the classified service).

If based on an initiative of the Agency Head, explain the program or project based on this initiative and the level and duration of this work.

Does the job require a unique background or qualifications? If so, what are they?

This duty and responsibility sheet must be included outlining the job duties by percentage (%) of time. Percentage must equal 100%. Include a comprehensive org chart that shows all positions and reporting relationship in the unit where the position is located. Note: An org chart must be included in order to proceed with the request. If not attached, the request will be returned without action.

DUTIES AND
RESPONSIBILITIES / Provide a brief statement describing the function of work or reason why the position exists. List duties including the percent of time spent for each area of responsibility. If applicable, describe any unusual physical demands and/or unavoidable hazards of the position. Attach additional pages if necessary.
If duty(s) are short-term/temporary and nonrecurring, note beginning and ending dates and percent of time required to perform the duty(s). Begin the writing of your short-term duty statement(s) as follows: (SHORT-TERM – beginning and ending dates) – Example: (SHORT-TERM – 1/1/99 through 1/31/99)…
PERCENTAGES
MUST
TOTAL 100% / LIST DUTIES IN DECREASING ORDER OF IMPORTANCE/COMPLEXITY. THE NEED FOR SPECIAL LICENSE, POLICE COMMISSION, KNOWLEDGE OR TRAINING MUST BE INDICATED BELOW, IF APPLICABLE.
AGENCY APPROVAL:
Signature of Appointing Authority or Designee:
Title of Person Signing this Request:
Contact Information: Name, E-Mail, Phone Number (including area code)
FOR CIVIL SERVICE USE ONLY
Signature of State Civil Service Director:
Shannon S. Templet, Director, State Civil Service / Approval Date:
Consultant’s Initials: / Log Number: / Request Number:
Date Entered: / Entered By:
Notes:

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CSUA1: Request for Exemption from the Classified Service