Employee Setup and Maintenance Form

Employee Setup and Maintenance Form *shaded fields generally do not come from PMIS

REQUEST New Employee Personal Information Change Job Information Change Time Reporter Data Change Work Schedule Change Comp Plan Enrollment Change

PERSONAL INFORMATION Biographical Details – Effective Date Prefix Suffix Person ID First Name Middle Name Last Name Address1 Address2 Address3 City State Postal County Eligible to Work in U.S.

Organizational Relationships - Org Relationship to Add Employee Contingent Worker Person of Interest

JOB INFORMATION Effective Date Action Work Location - Position Number Job Information - Job Code Reports To Department Department Entry Date Location

Payroll - Payroll Information Absence System options Absence Management (salaried) Other (Hourly)

Payroll for NA - Pay Group Employee Type H S BWH (hourly) SMS (salaried) (hourly) (salaried) *Absence Management System (complete this section for salaried employees only) Eligibility Group EXECELGGRP Pay Group : SEMIMNTHLY Setting: Use Pay Group Eligibility Eligibility Group TRADELGGRP Eligibility Group VSDPEDGGRP Pay Components - Comp Rate Compensation Pay Components - Rate Code Hourly Pay Rate (hourly employee) $______NAHRLY NAANNL Annual Salary (salaried employee) $______

1 of 2 Last Updated 11/30/2011 Employment Data – Organizational Assignment Data – Company Seniority Date

Benefits Program Participation – Benefits Program Participation Effective Date Benefit Program PSX

TIME REPORTER DATA Effective Date Workgroup Contract Hours – Hourly Contract Hours Contract Hours – Start Date Contract Hours – End Date

ASSIGN WORK SCHEDULE Effective Date Schedule ID (Typically the 1st day of the pay period)

COMP PLAN ENROLLMENT Effective Date Compensatory Time Off Plan COMP_LEAVE OT_LEAVE Status

For Use by the Employee Setup Administrator:

Entered By: ______Date: ______

2 of 2 Last Updated 11/30/2011