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Personnel Record PDF Details

A personnel record form is a document that stores information about an employee, such as their name, contact information, date of hire, and job title. This form can be used to track the progress of an employee within a company and document any disciplinary actions that have been taken against them. It is important for companies to keep accurate records on their employees in case there are any legal disputes or wrongful termination claims. A personnel record form template can make it easy for businesses to collect and store this information. When you're starting a new job, one of the first things you'll do is fill out some paperwork. This includes your Personnel Record Form.

In order to learn a few specific details relating to the PDF you're going to use, here's the facts you might want to study prior to completing the personnel record.

Question	Answer
Form Name	Personnel Record
Form Length	2 pages
Fillable?	Yes
Fillable fields	160
Avg. time to fill out	32 min 34 sec
Other names	lic 501a, lic501, lic 501 personnel record, lic 501 form

12

Form Preview Example

STATE OF CALIFORNIA—HEALTH AND HUMAN SERVICES AGENCY

PERSONNEL RECORD

(Form to be completed by employee)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES

DATE

NAME OF FACILITY

FACILITY ADDRESS

FACILITY FILE NUMBER

1.PERSONAL

NAME (LAST	FIRST	MIDDLE)	TELEPHONE

						(		)
ADDRESS							ARE YOU 18 YEARS OF AGE OR OLDER?
							■ YES	■ NO	IF NO, PLEASE STATE YOUR AGE
									_____________________________

SOCIAL SECURITY NUMBER: (VOLUNTARY FOR ID ONLY)			DATE OF LAST PHYSICAL EXAMINATION				DATE OF LAST TB TEST
-	-

HAVE YOU EVER BEEN EMPLOYED UNDER A DIFFERENT NAME? ■ YES ■ NO				IF YES, PLEASE LIST ALL NAMES USED.

DO YOU POSSESS A VALID CALIFORNIA DRIVER'S LICENSE?		■ YES ■ NO				HAS YOUR DRIVER'S LICENSE EVER BEEN SUSPENDED OR REVOKED? ■ YES ■ NO
CDL NUMBER						IF YES, PLEASE EXPLAIN ON BACK OF FORM.
NEAREST LIVING RELATIVE — NAME:							TELEPHONE NUMBER			RELATIONSHIP

ADDRESS

2.POSITION

TITLE

SALARY

HOURS

DATE OF EMPLOYMENT

NAME OF SUPERVISOR

3.PREVIOUS EMPLOYMENT (List most recent experience first. If additional space is needed, please attach a separate page.)

NAME AND ADDRESS OF EMPLOYER

TELEPHONE

NUMBER

JOB TITLE AND TYPE OF WORK

REASON FOR

LEAVING

DATES

FROM TO

4.EDUCATION

CIRCLE HIGHEST YEAR COMPLETED

6

7

8

9

10

11

12

DIPLOMA

CURRENTLY ENROLLED IN HIGH SCHOOL COMPLETION COURSE?

■ NO	■ YES IF YES, GIVE EXPECTED COMPLETION DATE___________________

EMPLOYMENT — RELATED EDUCATION COURSES

COURSE TITLE

NAME OF SCHOOL OR ORGANIZATION

AND ADDRESS

NUMBERDATE CURRENTLY UNITS

COMPLETED COMPLETED ENROLLED

LIC 501 (3/99)

(OVER)

4.EDUCATION (CONTINUED)

NAME UNIVERSITY, COLLEGE OR BUSINESS SCHOOL

AND ADDRESS

MAJOR

SUBJECT

NO. OF	NO. OF	DIPLOMA
YEARS	UNITS	DEGREE OR	DATE
COMPLETED	COMPLETED	CERTIFICATE	COMPLETED

5. REFERENCES

List names of three persons who can give information about your background, character, abilities, etc.

NAME

ADDRESS

TELEPHONE

NUMBER

RELATIONSHIP TO YOU

(FRIEND, EMPLOYER, ETC.)

6.PROFESSIONAL AND TECHNICAL QUALIFICATIONS

A.List Licenses or Certificates of Competence held:

B.Names of Professional Associations of which you are a member:

NOTES:

I hereby certify under penalty of perjury that the above statements are true and correct. I give my permission for any necessary verification.

SIGNATURE OF EMPLOYEE

DATE

How to Edit Personnel Record Online for Free

The whole process of filling out the cdss lic 501 is actually comparatively effortless. We ensured our editor is not difficult to utilize and helps prepare just about any PDF within minutes. Take a look at a few simple steps you will need to take:

Step 1: Find the button "Get Form Here" on the site and select it.

Step 2: At the moment you're on the file editing page. You can modify and add information to the document, highlight words and phrases, cross or check certain words, include images, insert a signature on it, erase unrequired areas, or remove them altogether.

Complete the particular areas to fill out the document:

step 1 to writing lic 501 form

Type in the expected particulars in the box CD, L, NUMBER, NEAREST, LIVING, RELATIVE, NAME TELEPHONE, NUMBER RELATIONSHIP, ADDRESS, TITLE, NAME, OF, SUPERVISOR POSITION, SALARY HOURS, DATE, OF, EMPLOYMENT NAME, AND, ADDRESS, OF, EMPLOYER TELEPHONE, NUMBER, JOB, TITLE, AND, TYPE, OF, WORK REASON, FOR and LEAVING.

part 2 to completing lic 501 form

The software will require particulars to easily fill up the box CIRCLE, HIGHEST, YEAR, COMPLETED DIPLOMA, YES, IF, YES, GIVE, EXPECTED, COMPLETION, DATE EMPLOYMENT, RELATED, EDUCATION, COURSES COURSE, TITLE NAME, OF, SCHOOL, OR, ORGANIZATION AND, ADDRESS LI, C OVER, NUMBER, UNITS, COMPLETED, DATE, COMPLETED, and CURRENTLY, ENROLLED

stage 3 to finishing lic 501 form

The AND, ADDRESS SUBJECT, REFERENCES, NAME, ADDRESS, TELEPHONE, NUMBER, RELATIONSHIP, TO, YOU and FRIEND, EMPLOYER, ETC segment may be used to point out the rights and responsibilities of both parties.

step 4 to completing lic 501 form

Look at the fields NOTES and then fill them in.

Completing lic 501 form stage 5

Step 3: Choose the Done button to save your document. Now it is readily available for transfer to your gadget.

Step 4: Come up with a duplicate of every document. It's going to save you some time and allow you to stay clear of misunderstandings down the road. Keep in mind, your data is not revealed or monitored by us.

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