Please complete all checked
TEACHER SERVICE
LAST FIRST MI
columns 1-6, 8-11, & 13)
and return ASAP. RECORD
SOCIAL SECURITY NUMBER Instructions for completing
this form are on the back El Paso Independent School District
side, all columns must be 1014 N. Stanton
completed unless otherwise El Paso, Texas 79902
SIGNATURE OF TEACHER indicated.
1 2 3 4 5 6 7 8 9 10 11 12 13
Dates of Service (a) State Sick Leave Program
School State County School District Or Public Position Years %of No. Full (b) State Personal Leave Program Authorized Signature,
Year Or Or Institution Or Held of Day Days Sem. From To Title &
Country Equivalent Private Exper. Emp. Emp. If <90 Prior Earned Used End-of- Organization
days Year Year Official Stamp
Balance Balance
(a)
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(b)
(a)
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(b)
(a)
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(b)
(a)
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(b)
(a)
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(b)
(a)
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(b)
(a)
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(b)
(a)
Please sign on diagonal line
-------- with title below signature.
(b)
Note: Instructions on Back FIN 115 (1/16/2016)
Instructions for completing FIN-115
(All columns must be completed unless otherwise indicated)
1. School Year -- Corresponds to the scholastic school year (e.g., 1997-98, etc.) employment is claimed. No more than one year of experience can be shown on one line.
2. State / Country -- Enter state or territory of the USA. Enter name of foreign nation if applicable.
3. County / Equivalent -- Enter county or parish in USA. For Department of Defense Education Activity (DoDEA), enter the names of sub-territories of foreign nations. DoDEA Service must be completed by National Archives and Records
Administration (NARA). Send a blank service record to: National Personnel Records Center, Civilian Personnel Records, 1411 Boulder Blvd., Valmeyer, IL 62295.
4. School District or Institution -- Enter name of public school district or institution and name of private school or institution. Give sufficient information in this column to identify the school for accreditation purposes.
5. Public or Private -- Enter either Public or Private, for the British System enter either Government or Public
6. Position Held -- Enter position held (e.g., teacher, librarian, substitute, bus driver, aide, etc.)
7. Years of Experience -- Enter the number of year(s) of actual experience as of September 1, of the school year indicated in column 1. (Do not include the additional year(s) for career ladder, career and technology education work experience, or
qualified teacher aide experience. Career and technology education work experience or qualified teacher aide experience must be recorded as a footnote on the service record).
8. % of Day Employed -- Enter percentage of the school day the employee was employed. Full day is reported as 100%, one-half day is reported as 50%, three-quarters of the day is reported as 75%, etc.
9. No. of Days Employed -- Enter the number of days employed during the contractual year (July 1 through June 30). The days entered must not include the number of days a person was docked a full day’s pay.
10. Indicate if a full semester, -- Enter full semester if it was a full semester that was less than 90 days.
if it is less than 90 days
11. Dates of Service -- Enter the actual beginning date of employment and actual ending date of employment during the contractual year (July 1 thru June 30).
12. State Sick & Personal Leave:
(a) State Sick Leave -- Enter state sick leave information in this row – not required for private schools, colleges, and out-of-state schools.
(b) State Personal Leave -- Enter state personal leave information in this row (Required for Charter schools if state days are offered) – not required for private schools, colleges, and out-of-state schools. (Note: This program was initiated in 1995-96
school year).
13. Authorized Signature, Title,
and Organization Official Stamp -- The record must be verified by either signing each line of the record separately (in ink) or by drawing a diagonal line and placing the signature diagonally across from the years of experience. An authorized official of the
school system must sign the record. A rubber stamp signature may be used, in lieu of the original signature, provided the name of the person appearing on the stamp is the same name designated by the school district to sign
the service record. Such official, if not the superintendent of the school, must have been authorized to sign personnel records of the institution by the governing board of that institution. In the case of public schools, the
board of trustees is the governing body. The organization’s official stamp must be included on the service record if service from overseas is reported. For public schools, colleges and universities, the country’s Department
of Education is the organization official stamp. If service is reported from the US, official stamp may be included depending on availability.
Note: -- All service claimed for salary increment purposes must be documented on this form or other similar document containing similar information.
-- Service records and supporting documents must be completed in ink (the document may be completed electronically and printed).
-- White out may not be used, any white out used on any document submitted will nullify the document.
