Document N2jVx6ZGjo2M88LeXNOmQBdBw

F-457A-WAGE 2-M 4-C9 \rf. s'.-----1-:-------7----------------------;---------- Date Issued V EMPLOYEE CHANGE REPORT 7If Transfer or ing Lis jt Date In L^aftment From Dept. Operation rv / Man no. ^ 1/ To Dept. Shift Operation Foreift/4 Jk Gen. Supt. or Fac. MgT. Inq. Rel EMPLOYEE LEAVING REPORT Other Gave Notice Laid Off Rec. For Discharge QuitW. O. Notice Leave of Abs. Pensioned Would Rehire Would Not Rehire Rehire Conditionally p r-/ec . y/kl /??. If Merit Tnc. J& llList Proposed Effective Date . PRESDNTTRATE JR W Date of Last Increase PROPOSED RATE JR DW RATING Quality Quantity Team Work Reliability Job Knowledge Adaptability FOR I.R. USE ONLY L. of A. Probable Date of Return Foreman n J _ .(Use Reverse Side For Additional Comments) Ind. Rel F_l+53- ^ev. 1-1*9 , ENCASEMENT SUP INSERT "Rf" if RE-fMP(.OVEDi T0: -------------J^lgLlIS/G. PFTPTf'V (FOREMAN) ' soc.sec.no. OEPT. ' DATE. 6/1/'/7, L .REPORT FOR^WOIRk EMPLOYEE'S _Sk, NATURE HIPED Bf .... Gf?0UP INS. ----- __--E0UCAT_!_0N--(j_RS.) grahma'b ^------ ------- M DB',4, vtb--------------------- - W------------ HOSPITALIZATfON __ Ur NU FOREMAN UNIR0000097