employee status change form template

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Easily create a permanent record for employee changes

Employee Status Change Form

This sample Employee Status Change Form template is a form used to standardize the process for recording, and where applicable approving changes to an employee’s employment matters and create a permanent record for the employee’s file.  NEW! Now includes preferred pronouns. 

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What is an Employee Status Change Form?

The Employee Status Change Form Template is an editable and flexible form that communicates and provides a permanent record of changes to an employee’s employment including:

  • Name change
  • Preferred pronoun change.
  • Address change
  • Direct deposit banking change
  • Employment status
  • Leaves
  • Return to work
  • Position status
  • Title
  • Reporting
  • Department transfer
  • Hours of work
  • Overtime eligibility
  • Increase in benefits or vacation
  • Disability accommodations requirements
  • Compensation changes.  

The form is completed electronically by an employee, manager or HR as follows, with a copy of the completed form kept in the employee’s file:  

  • Employees, HR and Managers use the Employee Status Change Form to communicate changes related to employees and to obtain approvals for changes where necessary.
  • The completer of the form prints, signs, scans and emails the form for appropriate approvals.
  • HR and Payroll ensure that the form is completed to comply with approval and audit processes.
  • HR is responsible for filing the form as a permanent record.

The Employee Status Change Form is divided into four sections:

  1. Reason for Change: Provides a list of status change options to choose from and fields with clear completion instructions.
  2. Compensation Change: Prompts the completer of the form to provide the information needed to process a compensation change.
  3.  Comments: A flexible field to elaborate on or provide additional comments for more complex changes.  
  4. Approvals:  This section of the form is provided for certain employee status changes that affect the budget or organizational chart that require approval prior to processing.

The Employee Status Change Form includes check boxes and grey shaded form fields with text that guide the completer of the form. Table cells will expand to accommodate any length of text and rows may be added or deleted.

Once completed, the Employee Status Change Form includes sensitive information, and without context, its content may be misunderstood. It is not to be shared with staff that does not have responsibility for direct reports. Caution and discretion must be used when printing. 

Why use an Employee Status Change Form?

Using an Employee Status Change Form is important because it:

  • Provides a permanent and if applicable, approved record of an employee change and effective date so that a progression of employee changes may be viewed at any time.
  • Provides a set format and structure that makes it easy for both the completer and recipient of the form to record changes.
  • Outlines approval requirements prior to accepting and processing of the employee-related change.

What you risk by not using an Employee Status Change Form?

If you don’t use an Employee Status Change Form:

  • Management will not be able to view an employee’s progression or various important changes that have occurred during employment.
  • Without an audit trail of changes, possible litigation and a solid defense will be challenging without accurate records.
  • Your employee changes, such as compensation changes, may be processed without approvals and may be an invitation for fraud.
  • Employees won’t have an easy-to-follow process or structure to submit changes, and so won’t!
  • Without an internal control mechanism in place, your auditors won’t be satisfied that your business has implemented a check-and-balance process so that no one person can willy-nilly make a change to a staff member’s position, compensation, benefits.

Small Business Tips

You may want to consider using Adobe Acrobat Pro for automating the Employee Status Change process. It works in conjunction with Word to generate fillable PDFs. You can also create a fillable form in Adobe.

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Employee Status Change Form

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Which HR kit is it included in?

The Employee Status Change Form can be used on its own as a stand-alone tool, or as part of the HR Administration Kit.



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