New Hire and Intergovernmental Transfer Form	*JURISDICTION CODE	*EFFECTIVE DATE
Transaction Codes:  02, IT	     		     	
	mm/dd/yyyy

Employee Information:

*Soc. Sec. Number	*First Name	MI	*Last Name	Suffix
      -     -        	     		 		     			

*Home Address 	Employee ID	Job No.
	*Street1	     		     		  		
	Street2	     		CAMPS Generated Codes – Enter only if known
	*City	     		*ST	  	 	*Zip	     	
	*EEO Ethnic
Email Address	*Date of Birth	*Gender	Code	Educ. Code
     		     							

*US Citizen Y/N	Immigration Number	Driver’s License Number	State of Issue	*Residency Code
		     		     		  		     	

Comments
     		

Appointment Information:
	*Appt.
* Transaction Code	Type	*Title Code	*Title Name
				     		     	

*Jurisdiction Name	*Jurisdiction Department	License Code
     		     		     	

	*Essential	*Salary Range	*Salary Range
*Comp. Method	Part Time %	Emp. Y/N	Minimum	Maximum
		     				     		     	

*Base Salary	Extra Salary	Interim Replaced Emp. ID	IA Thru Date
     		     		     		     	

* Work Week		Canvassed
  Hours	WTP Start Date	Certification No.	Exam Symbol No.	Special Legislation Citation	List Y/N
     		     		     		     		     				

Comments 	
     		

Authorizing Signatures:
The Appointing Authority takes responsibility for informing the employee and accepts responsibility for the accuracy of this request.

Appointing Authority:  I certify that the action requested conforms to Merit System Rules and Regulations.  This request has been made in accordance with legal requirements.

Signature of AA:       		Date:       		Title:       	

For Appointing Authority Use: 	x      		x      	

Submit to:  NJ Department of Personnel; CAMPS Forms, PO Box 354, Trenton, NJ, 08625-0354