1. Complete this form and attach:
--statement of need for WOC per WOC guidelines
--selection process used
--names of employees considered and
--name of employee selected.
2. Send completed form and documentation to your Management Team representative and to the Human Resources office.
3. Human Resources staff will present WOC request to management team. Approval from management team is required before the employee begins the assignment.
Reason for WOC:
Backfill: Filling behind an employee on leave, rotation, etc. and assigned all duties of the higher-level position. Attach higher-level position description signed by appointing authority.
Position under recruitment: Performing duties of vacant position not yet filled. Attach higher-level position description signed by appointing authority.
Limited period: Performing higher-level duties for a limited period. Attach employee’s current position description and written description of WOC duties.
Pending reclassification: Position is scheduled to be permanently reclassified upward. Attach position description and classification analysis supporting the higher classification. / 1. AGENCY NAME AND NUMBER
58100 Department of Education / 2. OFFICE/SECTION/UNIT
Click here to enter text.
3. EMPLOYEE NAME
Click here to enter text. / 4. SUPERVISOR NAME
Click here to enter text.
5. TYPE OF WOC ASSIGNMENT
Choose an item.
If Extension, what was original start date? Click here to enter a date.
Original expected end date Click here to enter a date.
New end date Click here to enter a date.
6. REASON FOR WOC ASSIGNMENT
Choose an item.
7. PROPOSED EFFECTIVE DATE OF WOC ASSIGNMENT Click here to enter a date.
8. ANTICIPATED ENDING DATE OF WOC ASSIGNMENT (Cannot exceed current biennium.) Click here to enter a date.
I have attached all required documentation.
SUPERVISOR SIGNATURE DATE PHONE NUMBER
HUMAN RESOURCES OFFICE USE ONLY BELOW THIS LINE
CURRENT CLASSIFICATION NUMBER AND TITLE / WOC CLASSIFICATIONNUMBER AND TITLE
CURRENT SR # and CURRENT PAY
CURRENT SED / WOC SR# and STEP NUMBER
WOC TYPE
q 5%
q 1st step of higher class
q next higher rate in higher class
DOES EMPLOYEE MEET MINIMUM QUALIFICATIONS
q Yes
q No (Requires appointing authority approval. Must maintain supporting rationale in personnel file.) / DIFFERENTIAL AMOUNT
PENDING UPWARD RECLASSIFICATION: Has reclassification package been submitted to ODE Budget Unit?
q Yes Date submitted ______
q No Date of planned submission ______
SIGNATURES:
WOC RECOMMENDED q YES q NO
______
HUMAN RESOURCES REP. SIGNATURE DATE
WOC APPROVED q YES q NO
______
APPOINTING AUTHORITY SIGNATURE DATE
cc: Employee
* Please refer to CBA or HRSD State Policy20.005.10 for information on correct WOC computation, or call a HRMC Consultant or LRU Manager.
Original: Employee Personnel File
Copy: Employee, Position file (If related to a reclass), HRMC File (for pre-approvals)