(Rev. 09/03} 2

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PAR ITEMS- LINES 8 AND 92.100(Rev. 09/03}ALPHABETICAL INDEXTITLEITEMAcademic Days Not Worked . , .Additional Position Substantiation . . .Adverse Action and Rejection Substantiation . . . .Alternate Salary Range Criteria . .Anniversary Date - Second Accelerated .Appointment Reorganization Substantiation . . . 1032.1242.1392.1422.1312.1042.148Deduction Information·. . 999Demotion Reason . 8562.1512.105Emergency Qualifying Time . 857Employment During Leave of Absence . 8902.1072.135Fl ag Clearance, Employment List Substantiation . 8592.109Health and Welfare Benefits . 8612.110Indeterminate Service Accumulation . . . 891Intermittent Hours Work Expected . 8632.1362.112Last Day on Pay Status . . 892Leav e of A bsence Substantiation, Special . . . 866Legal Reference for Annuitant . 864License - Additional . . . . 884Limited Term/Anniversary Date Justification . 867Lines 8 and 9 General Information . .List Clearance Date . . 8582.1372.1152.1132.1302.1172.1012.108Lump Sum Payment Deferral . . 8772.125Military Service Dates .: . . 964Military Substantiation . 865Multiple Hourly Rate . . . 9552.1502.1142.143Other Eligibility Appointment Substantiation . . 9572.144Reemployment List Eligibility Date . . 869Right of Return Designation . 871Salary Increase Certification ·. :. 872Salary Rate Substantiation, Above Minimum . 873Separation Pay at Alternate Salary Rate . 962Separation Time to be Paid Substantiation . . . 958Sick Leave at Retirement . 8882.1182.1192.1212.1222.1492.1472.133Temporary Authorization Clearance . 878Time Base Substantiation . . . . . 879Time-of Death . .:. 8802.1262.1272. 128Case Number and Date of Action . .Class Title Variation Code .Commitment Date .Corrected Transaction Identifier . . .ISECTION

2 .101(Rev. 08/95)LINE 8/9 ITEMS- fNFORMATfONGENERALINFORMATIONLines 8 and 9 items are reserved for information required forspecific transactions or to clarify other items on the PAR.Section 3 of the PAM on Required/Conditional charts gives the ·8/9 items that may be needed for the transaction beingdocumented. The actual entry required on line 8/9 is outlinedin the item definition section.DOCUMENTATIONFor entries on line 8/9, the three digit item number is writtento the left side of the broken vertical line. The codes, dates,etc., are placed to the right of the broken vertical line.When multiple codes, dates, etc. are required for one item, usedashes to separate them. Always enter six digits for dates withappropriate slashes.The total length of characters to be entered is stated in eachitem. This count includes alpha or numeric only and does notinclude dashes, slashes, colon, semicolon, decimals, commas,etc .Entries on line 8 or 9 need not be in numeric order. They canbe entered in any order within one line. Pre-coded boxes (e.g.805, 810, 905, 910, etc.) hold no value and should bedisregarded. Items in the 900 number series must be enteredon Line 9 only.ADDffiONALINFORMATIONThe shaded area of Line 8/9 is used for turnaround purposes.The following 8/9 items will turnaround· in the shaded area:85 7871876884886955(.- Emergency Qualifying Time- Right of Return Designation-Anniversary Date - Second Accelerated- License - Additional (maximum of 3 entries)- Class Title Variation Code- Multiple Hourly Rate (maximum of 4 entries)(continued on next page)C:\ WPS I \.DOCS\P/\M\2.1 0013

2.101.1(Rev. 08/95)LINE 8/9 ITEMS - INFORMATION (cont.)ADDffiONALINFORMATION(cont.)Lines 8/9 items are applied in the same manner for additions,deletions or changes as explained on PAM pages 3 .0 and 3 .2.For additional information on corrections to Line 8/ 9 items seeSection 9 of the PAM.Some Required/Conditional charts have "delete only" printedafter certain 8/9 titles. This means an 8/ 9 item showing inthe shaded area of the turnaround PAR may be deleted whileinitiating a transaction if it no longer applies to the employee'spresent status. To delete an 8/9 item, enter the item numherand *EOF.EXAMPLE:lli:FROM :TO :857!OS. ·- :---- ·--5'5 7i * .oFI8 0!To delete a code from an item when more than one entry isallowable, enter the item number and code(s) which still applyand enter the item number and *EOF for code(s) which nolonger apply.EXAMPLE:I .884 :1-04 / 10/ 9-5 .I.I.II.884 ·: 4-0.J/01/95* Eo F.I . . . . . .I.I-· -IIa g.i.L:10II. IIauII

2.102(Rev. 05/84)ITEM 850 - ADDITIONAL POSITION SUBSTANTIATIONDESCRIPTION:A code certifying appropriate attendance for necessarycoordination of employee benefits when employee holds anadditional position.REQUIRED:Upon initial appointment to an additional position.LENGTH:10 charactersENTER:850:Code (1 digit) - Date (if indicated below)CODESDEFINED:1· -Employee's additional work assignments and schedulewill not conflict with regular assignments and thattotal sick leave and vacation credits, State servicecredits, retirement contributions are beingcoordinated to insure that employee does not exceedfull time credit.2 -Plus date (mm/dd/yy) - (This code used for employeesin Work Week Groups 4B and 40 only.) The dateapproved by SPB analyst and that the total sickleave and vacation credits, State service credits,and r tirement contributions are being coordinatedto insure that employee does not exceed full timecredit.EXAt PLE:II9 TO: R50: 2-03/.30/8390S{II., 01

2 .103(Rev. 11/92)ITEM 851 - ALTERNATE SALARY RANGE CRITERIADESCRIPTION:Indicates the alphabetic or numeric code of the specific alternaterange criteria for which employee is qualified. Ranges are basedon educational, professional or experience qualifications and alsoon conditio or location of employment.REQUIRED:1. If the employee is:a. Changing from one alternate range to another - other thanto A; orb. Appointed to a different class at an alternate range otherthan A; orc.- Appointed to the same class at the same alternate range(other than A) and work experience is not the basis for thealternate range; ord. Appointed new to data base at an alternate range otherthan A.2. When an alternate range criteria is added to the employee'sclassifi.cation.LENGTH:6 charactersENTER:851:3 digit Alternate Range criteria code as shown in the CivilService Pay Scales.EXAMPLE: ROM:I .I@- - ---:- -'----TO:85"1: O(o5'-·-· ·--l1.I

2.104(Rev.02{ 6). .-ITEM 853 - COMMITMENT DATEDESCRIPTION:This item is used in order to verify the followingsituations:1-For employees who qualify under a "hire aboveminimum" rate but who do not fall under HAMdelegation to the departments, .a letter ofauthorization must be obtained from SPB or Finance.If a commitment is made before the expiration dateof the letter but effective date of appointment isafter the expiration date, this item must indicatethe date commitment was made.2-The commitment date must be indicated when effectivedate of appointment is after the expiration date ofthe certification from which eligible was appointed.3-The commitment date must be indic.ated whencommitment was made prior to rece·ipt of supplementalnames on an updated certification .REQUIRED:For AOl or A02 Transactions where abo·ve situations apply.LENGTH:9 charactersENTER:853:EXAMPLE:033lc5Date (mm/dd/yy)

(Rev. 05/90)2.105ITEM 856 - DEMOTION REASONDESCRIPTION:Explanation of employee's preference in voluntarilydemoting or choosing a demotion other than that which wasdirected (e.g., layoff, reassignment, etc.).REQUIRED:For A02 Transaction (Civil Service eligibility- permissivewhen employee is voluntarily demoting).LENGTH:5 charactersENTER:856:CodeCODESDEFINED:01 -Employee's illness or poor health.02-Change of career. Such as (1) employee development,(2) greater chance for promotion, (3) betterutilization of education or training, (4) differentfield of work.03 -Relocation of residence. Such as (1) spouse beingtransferred, (2) desire to work nearer family, (3)climate change for family health reasons.04 -Transportation difficulty. Such as (1) desire towork nearer residence, (2) commuting to anotheroffice is easier.05 -Conditions of employment. Such as (l) desire for adifferent shift, (2) less than full-time work, (3)want a field assignment, (4) want an officeassignment, (5) want less or no supervisoryresponsibility, (6) desire a job with less pressure,(7) lost license required to perform in the class .06 -To further education or personal development.07 -Layoff situation08 -Stipulation after appeal.09Misallocation of position or change in allocationstandards.10-In lieu of involuntary transfer.11 -Other - reason on file with the appointing power.EXAII1PLE:. ·1F.AOM .@ .e. ;· - ;;-. 033-1 c6/0084TO :. ''f .85bj D3 ;; i. ., ., .I . . . .:.t!j.,r.!:.,.- '

2. 107 (Rev. 03/99)ITEM 857 - EMERGENCY QUALIFYING TIMEDESCRIPTION:Indicates the total working days accumulated for emergencyappointments. This total time must be reported at the end of eachemergency appointment. Refer to SPB Rules 300 - 304 for explanation.I -REQUIRED:For S31 Transaction for separation of emergency employee.2 -For an appointment effective immediately after expiration of anemergency appointment and no separation was documented.3-When information no longer applies to employee's current status.LENGTH:Up to 5 charactersENTER:857:ltJi.-Number of Days from 00 to 60** (2 digits); or*EOF - Information no longer applies.ADDITIONALINFORMATION:This item will turnaround on the PAR in the Line 8/9 area for futurereference. Refer to PAM page 2. 101 for additional information.** When reporting emergency qualifying time for an employee who wasappointed to and worked more than 60 day during a true emergencyappointment (rule 302.1) , complete Items 857 and 215 as indicated infollowing example.EXAMPLE:Employee on true emergency appointment (rule 302. 1) worked a total of73 days.Item 857ftem 215-ADDITIONALEXAMPLES :enter "60" ("60'' is the most you can enter in this item)Enter "Emergency/73 days" (fype of emergency must beindicated [PAM 2.36] as well as total number ofemergency days worked.)FROM::,·F ROM:(O)857OSTO :TO :857857l·05*EOF'; .;:,' r--- ---- -- .85760

2.108(Rev. 05/84)ITEM 858 - LIST CLEARANCE DATEDESCRIPTION:This item indicates the DATE the certification list wascleared when:The list clearance was sent to SPB for SPBcentralized certification lists; orThe job referral was received from the SPB jobreferral system; orThe delegated certification list was cleared.REQUIRED:Appointment Transaction Code AOl (certification process)involving SPB centralized certification lists, SPB jobreferral system and delegated certification lists whentenure is P, Lor T (if name{s) certified on list).LENGTH:9 -charactersENTER:858:ADDITIONALINFORHATION:Date (!Tiil/dd/yy)This entry is not required for a TAU Appointment when nonames are certified.EXAMPLE:FROM:m-- -- -1-- --·- -gsg liD/LZ/&3TO ::: lIIIIII.Il

2.109(Rev. 11 /91 )ITEM 859 - FLAG CLEARANCE EMPLOYMENT LIST SUBSTANTIATIONDESCRIPTION :REQUIRED:This signifies that the eligible meets the flagrequirements on list clearance and substantiation restswith the departments subject to audit by PersonnelOperations and SPB.· Whenever the flag requirement must be met in order t o hi rean eligible from a certification.LENGTH:3 charactersENTER:859:(no other entry necessary)EXAI PLE::;- 0 11 1 r IQ/RLl T

2.110(Rev. 11 /88)ITEM 851 - HEALTH AND WELFARE BENEFITSDESCRIPTION :Designates Health and Welfare Benefits for an employee ina casual employment class. Refer to DPA Rule 599.691 formore information .REQUIRED:For AOl or A02 Transaction when employee is in a casualemployment class.LENGTH:4 charactersENTER:861:CodeCODESDEFINED :1 -If qualified . for State Benefits and elects toreceive State Benefits must waive payment by Stateinto Health & Welfare und and Vacation Fund. (Item505 must be code "08" · or "04" . )2 -If qualified for State Benefits and elects not toreceive State Benefits must elect instead payment byState into Health & Welfare Fund and Vacation un dor for non-union members - direct payment toemployee. (Item 505 must be code " H" or "NA".)(1digit)3 -If not qualified for State Benefits and if there ispayment by State into Health & Welfare Fund andVacation Fund must accept payment by State into' these funds, or for non-union members -di r ect .payment to employee . {Item 505 must be code "1-.JH"or"NA".).4 -If qualified for State Benefits and if there is notyet approved payment by State into Health & WelfareFund and Vacation Fund and elects to receive StateBenefits. (I tern 505 must be code "03" or 04". )'115 -If qualified for State Benefits and if there is notyet approved payment by State into Health &WelfareFund and Vacation Fund and elects not to receiveState Benefits. (Item 505 must be code "N" or "NM".)6 -If not qualified for State Benefits and if there isnot yet approv d payment by State into Health &Welfare Fund and Vacation Fund and does not receiveany benefits. (Item 505 must be code "N or N! 111(continued on next page)0331 cl 01111.}

2.110.1(Rev. 07/83)ITEt-1 861 - HEALTH AND WELFARE BENEFITS (CONT.)ADDITIONALINFORMATION :The appointing power is responsible for obtaining a signedstatement from the employee to indicate the Health & ·Welfare Benefits employee will receive. Refer to PTHSection 238 for more information.EXAMPLE: ROM ::Im--- --- -- -- --- · :TO:2f J.,l5I.!I

2.111(Rev. 10/82)ITEt1 862 - UNASSIGNEDThis item is not to be used at this time.l

2.112(Rev. 02/85)ITEM 863 - INTERMITTENT HOURS WORK EXPECTEDDESCRIPTION:This is a code indicating the number of hours anintenmittent is expected to work.REQUIRED:l)For appointment or change to intermittent time basewhen tenure (Item 410) is P, T or L; orEXCEPTION:2)For 335 Transaction when time base is intermittentand the number of hours expected to work is changing.LENGTH:5 charactersENTER:863:Code (2 digits)CODESDEFINED:01 -under 25 hours per pay period02 -25-50 hours per pay period03-51-86 hours per pay period04 -87-100 hours per pay period.05 -101 -125 hours per pay period06 -126-150 hours per pay period07 -average of 1ess than 87 hours per pay pe.ri od over 6months08 -averag.e of 87 or more hours per pay period over 6months09 -full time for periods averaging less than 1/2 timeover a year10 -full time for periods averaging 1/2 and 3/4 timeover a year11 -full time certain periods during the year12-in excess of full time for certain periods duringthe year\)lNot required for mandatory reinstatementswhen time base or hours are not changing.EXAMPlE:0331 cl3

2.113 (Rev. 11/00)ITEM 864- LEGAL REFERENCE FOR ANNUITANTDESCRIPTION: IREQUIRED:LENGTH:ENTER:CODESDEFINED:The Government Code or Education Code which denotes a specificreference to the law and under which a retired annuitant is legallyappointed.For A01 - A04, A30- A33 Transactions to appoint a RetiredAnnuitant.10 characters.824: 3921EC23922Subject to·GC19144Subject to GC19144EXAMPLE:FROM::IIIII 864IIITO:*IGC21225laos110IIIIIPer Senate Bill 541 (effective 01/0 1196) and Senate Bill1595 (effective 01/01198) the following Government Codeswere 1224212252122821221

2.114(Rev. 10/79)ITEM 865 - mLITARY SUBSTANTIATIONDESCRIPTION :The total length of active duty when an emp loyee is givena military leave of absence and when mandatorilyreinstating an employee after a resignation to joinmilitary service (G.C. 19783). · This information isrequired for verification of reinstatement eligibility atthe time of r turn to State service: Length of activeduty is obtained from the military orders. See PTMSection 471 for computation.REQUIRED:For the following transactions:551S52S53A03-LENGTH:7 charactersENTER :865:ENTRIESDEFINED :Military- Short TermMilitary- Long TermMilitary - EmergencyMandatory Reinstatement (when employee hasmandatory rights after resigning to joinmilitary service per G.C. 19783)#years {1 digit} - ##monthstenths of months (!digit)!(2digits) -Tenths of months - formula for partial months is 3calendar days equals 1/10 of a month. Divide 3 intonumber of days to find tenths of months.7EXA! PLEA:23 days 3/TI 8/102127EXAMPLE 8:22 days 3 7/10-,21EXAMPLE:B l o l · g6S; .3 -oG,- o .I.e o I. ate::**This is an example of 3 years 6 mos.

2. 11 5(Rev. 05/11)ITEM 866 LEAVE OF ABSENCE SUBSTANTIATION, SPECIALDESCRIPTION: Denotes substantiation to the Special Leave authorized for a Veteran'sEducation or Job Incurred Illness or Injury.REQUIRED:1-For S55 Transaction- Veteran's Education Leave of Absence. This leaverequires the following : Date Form 718 was given to employee.Number of years, months and/or days of school (total entitlement) up to amaximum of 4 years, 3 months as specified in G. C. Section 19341.Date of enrollment in school and the length of school year.For an extension of this type of leave, a memo stating the reason must beattached to the PAR.For computing the expiration date or length of the leave see PTM Section 500.2-For S56 Transaction- Special Leave of Absence due to Job Incurred Illness orInjury. This leave requires either: Date of last paid temporary disability day. (to be used when the employeeexhausts the maximum temporary disability benefit but has not been declaredpermanent and statuary nor returned to work) Date of Permanent Disability Award ; or Date employee started rehabilitation training.The effective date of the leave cannot be earlier than the date mentioned above.LENGTH: Up to 23 charactersENTER:866:Code - mm/dd/yy - y/mm/dd - mm/dd/yy - tJ:.#; orCode - mm/dd/yyIf entry will exceed 18 characters, including item number, make entry in Line 9.CODES DEFINED: Entries for Veteran's Education Leave of AbsenceCode A- plus the following:mm/dd/w - date Form 718 was given to employee.y/mm/dd -number of years, months and/or days of schoolenrollment.(continued on next page)

2.116 (Rev. 08/12)TEM 866 - LEAVE OF ABSENCE SUBSTANTIATION, SPECIAL (cont.)CODES DEFINED (Cont.):mm/dd/yy - date of enrollment.## - length of school year in terms of months.Code D - Extension of Leave of Absence.Attach a memo to the PAR stating the reason for extension ofleave. Line 10 - Remarks, should have appropriate boxchecked "Substantiation Attached".Entries for Special Leave of Absence due to Job Incurred Illness or InjuryCode E - (mm/dd/yy) -Date of permanent disability award.Code F - (mm/dd/yy) -Date employee begins rehabilitation training, orlast paid date of temporary disability.EXAMPLE:Veter

For AOl or A02 Transactions where abo·ve situations apply. 9 characters 853: Date (mm/dd/yy) DESCRIPTION: REQUIRED: LENGTH: ENTER: CODES DEFINED: EXAII1PLE: 033-1 c6/0084 2.105 (Rev. 05/90) ITEM 856 - DEMOTION REASON Explanation of employee's preference in voluntarily demoting or choosing a demotion other than that which was directed (e.g., layoff, reassignment, etc.). For A02 Transaction .

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