TRANSFER REQUEST

Candidate Instructions:

Complete Section 1 and send to the Appointing Authority with a current resume.

FULL NAME OF EMPLOYEE

SECTION 1 TO

BE COMPLETED BY EMPLOYEE REQUESTING TRANSFER EMAIL ADDRESS

PHONE NUMBER:

TRANSFER REQUESTED FROM

CIVIL

SERVICE AGENCY

CURRENT

EMPLOYER

(COUNTY, CITY, TOWN, VILLAGE, SCHOOL

DISTRICT OR OTHER

)

CURRENT JOB TITLE

I

GIVE MY CONSENT FOR ONTARIO COUNTY DEPARTMENT OF HUMAN RESOURCES TO ACQUIRE MY CIVIL SERVICE EMPLOYMENT RECORDS. SIGNATURE

DATE:

PRINTED NAME

SECTION 2 BE

COMPLETED BY TO TRANSFER REQUESTED TO

DEPARTMENT

NAME OF COUNTY, CITY, TOWN, VILLAGE, SCHOOL DISTRICT OR OTHER

NAME

OF DEPARTMENT

POSITION

REQUESTING TO FILL

APPROVAL

OF DEPARTMENT HEAD

DATE:

PRINTED NAME OF DEPARTMENT HEAD

TITLE:

(SPACE

BELOW FOR USE BY ONTARIO COUNTY DIRECTOR OF HUMAN RESOURCES

)

ONTARIO COUNTY DIRECTOR OF HUMAN RESOURCES ACTION

SECTION 3 o

APPROVED

o

DISAPPROVED BY

TITLE:

DATE: