Free Statement - District Court of Arizona - Arizona

EXHIBIT I9
Case 2:03—cv—02300—ROS Document 93-28 Filed 05/30/2006 Page10f2

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of P l nel Mana ement‘ {T T}-- l ' ' Q-WK
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FPM amp. zgaaasfréubch. 4 Q `INOTIFICATION OF PERSONNEL Af..·~r’ ON _ 6*4 M5 _
1. Name {Last Firso Middle) ~I 2 Social Security-Number 3. Date of Birth ‘ 4. Effective Dale .·
PV!-Ei RUPENT L . . . .... .. ...._. 53 T:·6§‘1¤53.3.,. , _..,_.. .. .§2:·_%.8f§&._ ·_ ,_ · _
AGTION?;.» . . A
g Zlode 5-3. Nature of Action ‘··‘ ‘ · 6-A. Code B-B. Nature of Action ` '4-` ' ~ l l I ` ` V
.;· I ¤. ‘ ·s
` 5-C. Code _ 5-D. Legal Authority 6-C. Code E-D. Legal Authority ‘
. H R E 3 3 D 2 C s P r
5-E. Code 5-F. Legal Authority SE. Code 6-F. Legal Authority _
7. FROM: Position Title and Number 15. T0: Position Title and Number U
PHARMACY TECHNICIAN y ‘ COMPUTER SPECIALIST .
I] 2 91 T A l L G3 1 T1 A
8. Pay Plan 9. Occ. Code 10. Grarieiuwel 11. Steplltata 12. Total Salary 13. Pay Basis 6.Fay Plan 11. Occ. Code 1B.GmdBl'l.ove1 19. SteplRate 2D. Tmal Salary/Award 21. Pay
- GS 066}. G6 OI. I 25 435 PA GS 0334 G5 _ OS $25 360 PA
12A. Basic Pay 12B. Localrty Adj. 126. Ad;. Basic Pay 12lJ. other Pay 20A. Basic Pay 20B. Locality Adj. 200. Adj. Basic Pay 2ilil.0ii1er Pay
_ . 23 820 I. *515 25 6-35 $0 $2*t· 218 $1 542 $25 S60 $0
i ' .14. Nameand Location of Positi¤n’s Organization 22. Name and Location ol Position's Organization
_ VA MEDICAL CENTER VA MEDICAL CENTER _
ALLI ED HEALTH SVCS PHARMACY SERVICE INFORMATION RESEJIJRCE SANAGEHENT SVC
PHOENIX AZ PHOENIX AZ .
EMPLQPEE- DATA- ‘ ‘.:.-.l· -· o `‘=‘: -i*·:iii;;s-it .»·= ..;.=.....
23. Veterans Preference _ ‘ 24. Tenure ` 25. Agency Use 26. Veterans Preference for FIIF
z ‘ l1§%%i... iZI&i·’§liil'.%Li?a*’,tE’..l.l. §:I&i»Slli&'i:'.........la..¤,. z i’:i»*:i;...... 5:%::,%:2*::* [ x YES | N0
_ , .... EEGLI 28. Annuitant Indicator 29. Pay Ftate Determinant
BASIC LIFE GNL? 9 HOT APPLICABLE O .
30. Retirement Plan F LE R S g 31. Service Comp. Dale (Leave) 32. Work Schedule _ 33. Part-Time Hours Per
.+< ma it - . ..<>·=:;¤¤:ar·. t - F.._......I‘¥'*-ietI.¥?*?. - . _ - .... .
POSITION DATA. ‘ - ` ‘ . I `’’‘ rei; ‘· rr C `‘`" izli Y i i’`t- ..`'‘ 2* P -. -. "
·I 34. Position Occupied N I 35. FLSA Category SS. Appropriation Code 37. Bargaining Unit Status
I 2 azgxagiiazwgjsazace 3:252 gggglanmwm m Sjiilgfémpr 8492. 209 Z _ SOS 5 t, _
1 38. Duty Station Code 39. Duty Station (City- County —Stale or Overseas Location)
‘ O4--0370-013 PI-IBEHIX . AZ l `
Ao. Aoencv oATA 41.; 42. i 44. ·
I 45. Remarks _
. I SELECTED F*‘¤i" " PVA00—279B1 DATED-10/19/OO' ~
B A T E D * I
SALARY INCLUDES A LDCALITY-BASED PAYBENT BF 5.782.
POSITION HAS KNOWN PRDHCITIGH POTENTIAL. BETERHINATION oa
PROMOTION TD NEXT HIGHER GRADE TB BE HADE ST *12·—O2···ZGD].
_ _ -- __ EXHIBIT 19
`iy l Q . _J
s.-ainploying Department or Agency _ ` 50. SignaturelAuthentication and Title of Approving Ofiioial _
CEEPAFLT {E?-ST EE JTETIE-IAFIS AFFAIRS L ‘ - ’.` " - T"?-;·~<"‘..·,—-".Q;;rQ.§~——-I
47. Agency Code 48. Personnel Office ID ` 49. Approval Date ’ '
‘iA TA `§.??`l’ 12-01-‘2Ut'Jt} PERSONNEL OFFICES
5-Pan 50-316 Editions Prior to TIQ1 Are Not Usable Alter GISOIBS
y _ ‘ 2 - 0l=1= Copy - Long-Term nemo - oo nor oesrnov NSN TW-P1-333-6238
Case 2 :03—cv—02300—FiOS Document 93-28 Filed 05/30/2006 Page 2 of 2

Case 2:03-cv-02300-ROS

Document 93-28

Filed 05/30/2006

Page 1 of 2

Case 2:03-cv-02300-ROS

Document 93-28

Filed 05/30/2006

Page 2 of 2