— Employee Action Form
Job: —
Action Type
New Hire
Re-Hire
Separation
Attendance / LOA
Status Change
Other
Employee
Crew member (autofills name + number)
— pick from crew or type below —
Last name
First name
Middle
Employee #
Street address
City
State
Zip
Cell
Email
Emergency contact
Contact phone
Relation
SSN, birth date, and marital status are completed by HR on the office copy — not collected in the field.
Employment (new hire / re-hire)
Status
Full Time
Part Time
Hourly
Salaried
Hire date
Re-hire date
Position / trade title
Compensation ($)
Per
Per Hour
Per Year
Attendance / Leave of Absence
Reason
Vacation
Sick
Disability
Other
Start date
Return date
# paid hours
# unpaid days
Notes (work-related? reason for LOA?)
Status Change
Reason
Rate of Pay
Job Transfer
Work Classification
Other
Effective date
Prior
New
Separation
Effective date
Reason
Laid Off – Permanent
Laid Off – Temporary
Resigned
Suspended
Discharged for Cause
If discharged — cause
Poor Performance
Poor Attendance
Job Abandonment
Poor Attitude
Safety Violation(s)
Failed Drug Test
Unauthorized in USA
Theft
Insubordination
Other
Eligible for re-hire?
Yes
No
Returned company property?
Yes
No
N/A
Comments
Employee Signature
clear
Supervisor
Supervisor name (print)
clear
Email the PDF
Send to (supervisor email)
Routed automatically to this employee's timesheet approver.
✓ Save EAF — PDF to Archive & Email
↩ Send Back for Changes
Fills the official EAF, signs it, and files the PDF in the job document archive under EAF.
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— Employee Action Form