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<br /> <br />21.Supervision and/or Oversight <br /> <br />The scope and type of responsibility that you exercise as a supervisor or lead worker of other employees. <br />(SupervisorÓs comments <br /> <br />regarding this information may be provided on Page 5 in the Supe <br /> <br />Do you supervise or have oversight of other positions: Yes, continue in this box No, continue to next section <br /> <br />Please check all that apply: <br /> N/A Work Group/Team Unit/Section Department Division Organization <br />List the positions by title, along with number of individuals within the position, that you have responsibility for: <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />For the positions listed above, do you effectively recommend or <br />Effectively Take Effectively Take <br /> <br />Recommend Action Recommend Action <br /> Hire Suspend <br /> <br /> Assign Work Terminate <br /> <br /> Direct Work Discipline (Oral Reprimand) <br /> <br /> Reward Discipline (Written Reprimand) <br /> <br /> Transfer Evaluate Performance <br /> <br /> Promote Demote <br /> <br /> Adjust Grievances Coach and/or Counsel <br /> <br /> Train Develop Staff Schedules <br /> <br /> Inspect Work Other <br /> <br /> <br /> <br /> <br /> <br />SupervisorÔs Comments <br />( <br />To be completed by immediate supervisor of employee) <br />Are the statements provided by the employee accurate and complet Yes No Please indicate any inaccuracies or incomplete items. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />I certify that the answers to the above questions are my own and to the best of my knowledge and belief are correct and comple. <br /> <br /> <br /> <br /> <br /> Employee Signature Date <br /> <br /> <br /> <br /> Supervisor or Dept/Div Head Signature Date <br /> Page 5 <br />