Panera

Ozark Breads, Inc.

Personnel Change Notice
Proposed Personal Data Changes:
     
Store Nbr:  Location:   Emplyee Harvest: SSN:
     
First Name: Middle:
 Last Name:
Addrerss 1   Address
 
City State:
 Zip:
Home Phone:
 Cell Phone:
 Birthdate:
 
Employment Data: 
 
:

 
 
 Change Status to:
 Effective Date:
 
Salary Data: 
 
:

 
 
 New Pay Rate:
 Effective Date:

 
 
 Bonus:
 Effective Date:

Approvals:

 
 Department Manager/Supervisor Signature:
Date:  

 
 Operating Partner
Date: