STATE OF FLORIDA

DEPARTMENT OF ECONOMIC OPPORTUNITY

OPS WORK ASSIGNMENT SHEET

1.	PROCESS AREA:

7.	EMPLOYEE NAME:
Department of Economic Opportunity
2.	PROCESS UNIT:

8.	SOCIAL SECURITY NUMBER:
3.	SECTION:

9.	COMPARABLE CAREER SERVICE CLASS:
4.	SUBSECTION:

10.	LOCATION NUMBER:
5.	COUNTY:

11.	POSITION NUMBER:
6.	CITY:

12.	COMMENTS:
13.	Funding Source: Grant Number: Percent	Grant Number: Percent

Grant Number: Percent	Grant Number: Percent
14.	PREVIOUS OPS EMPLOYMENT WITH DEO:

FROM:	TO:	FROM:	TO:
15.	PERIOD OF EMPLOYMENT:

FROM:	TO:
PART TIME
FULL TIME/HOURS PER WEEK
WILL THIS APPOINTMENT EXCEED 90 DAYS?
YES
NO
16.	OPS EMPLOYMENT CATEGORY:

TEMPORARY
CONSULTANT
SUMMER YOUTH STUDENT OR

GRADUATE ASSISTANT

COOP-EDUCATION STUDENT
17.	JUSTIFICATION:

18.	DUTIES AND RESPONSIBILITIES:

19.	I HEREBY CERTIFY THAT THE INFORMATION SUPPLIED ABOVE IS CORRECT, THAT THE DUTIES AND RESPONSIBILITES DESCRIBED ARE ACCURATE AND THAT A COPY OF THIS FORM AND THE TERMS AND CONDITIONS OF OTHER PERSONAL SERVICES EMPLOYMENT HAVE BEEN FURNISHED TO THE EMPLOYEE. I FURTHER CERTIFY THAT THIS OPS EMPLOYEE WILL NOT BE PERFORMING THE DUTIES OF ANY VACANT, AUTHORIZED, OR ESTABLISHED POSITION.

REQUESTED BY:

TITLE:

DATE:

20.

APPROVED BY:

AUTHORIZED SIGNATURE

TITLE:

DATE:

DEO Form HRM-20 (Rev. 08/11)

STATE OF FLORIDA

OSAS

2013-09-30

Jackie McGill

FDLES J&B OIT