..
r _ ~ r_.
COMMISSIONERS' CQURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND FIVE COPIES OF THIS REQUEST AND
DOCUMENTS TO BE REVIEWED BY THE COURT
MADE BY: _ PAULA RECTOR
MEETING DATE: ocT. ~5. 1991
OFFICE: TAX ASSESSOR COLLECTOR
TIME PREFERRED:
SUBJECT: (PLEASE BE SPECIFIC) HIRING OF PATSY T,~NNFT,T, uANx~
__ IN THE AUTO REGT_STRATT(1N ANI~ TTTT F nFPARTMF tm AT A 1 n~/1 $1 2 _ 59~ nn ANN[TAI,
51.049.45 Mn_ FT'FF(`TTVF. 9/1 F/Q1
EXECUTIVE SESSION REDUESTED: YES __,___NO
PLEASE STATE REASON FOR EXECUTIVE SESSION
ESTIMATED LENGTH OF PRESENTATION: 5 MIN
PERSONNEL MATTER - NAME OF EMPLOYEE: _P~ut,a RECTOR
NAME OF PERSON ADDRESSING THE COURT:
Time for submitting this request for Court to assure that the matter is posted in accordance
with Article 6252-17 1s as follows:
* Meetings held on second Monday: 12:00 P.M. previous Wednesday
~ Meetings held on Thursdays: 5:00 P.M. previous Thursday
TNIS REQUEST RECEIVED BY: ~
TN I S REQUEST RECEIVED ON : _/~ - ~~ ~' 9~ ~ -~ : 'f -'~
All Agenda Requests will be screened by the County Judge's Office to determine 1f
adequate information has been prepared for the Court's formal consideration and action
at time of Court meetings. Your cooperation will be appreciated and contribute towards
your request being addressed at the earliest opportunity. See Agenda Request
Guidelines.
\ _...,.nt_ REp~RT
R C~~NTY MEp~C certify that f
KKR hereby and
T~ ~oPYI sed physician ~ t
App~ICAN a licen ~,,,~e,~l ~-I~itcs hyslcai defects tha
~ 1'aT~ any p
~o}~ ed, and free from
~'~ `~ tally examen ties as
f ~~ med' conditt°n of hislher dU
this date ~ hysicai
sound f} erformance nn'',,
have be in affect the p '~ .~`
on tY~
find htm~her to or adVer$ely ,--- ~~1c
revers ~ ~,~I~ c~-~~- .~--'' ~
could P ~. ~ - ~,~,~
~~ ~S~Q.~~ re of ysician
Sig
f'"~..--
~cense Number
pate ~ prysician SY UEpAHSMEHS
RHED SD KtiHft CpUH
PLI~p~IS SD ~~ RESU
SHIS p~HS10~ SO Ap
PUEAS~ ~,IV~
HEpp.
~K.pS


TEXAS WORKERS' COMPENSATION COMMISSION
200 East Riverside, Austin, Texas 78704-1287
(512) 448-7934
WAIVER OF CONFIDENTIALITY
I understand all information in my worker's compensation file(s) is confidential under the Texas Worker's
Compensation Act. However, I hereby waive any such right of confidentiality and authorize the information
outlined below from my records to be released to the undersigned employer for a period not to exceed fourteen
days from the date of application for employment.
SECTION 2.33. INFORMATION AVAILABLE TO PROSPECTIVE EMPLOYERS. (a) When a person applies for
employment, the prospective employer who has workers' compensation insurance coverage is entitled, on
compliance with this chapter, to obtain information on the applicant's prior injuries. (b) The employer must
make the request by telephone or file the request in writing not more than 14 days after the date on which the
application for employment is made. (c) The request must include the applicant's name, address, and social
~~ security number. (d) Ti:~~ employer must obtain written authorization from the applicant before making the
request. (e) If the request is made in writing, the authorization shall be filed simultaneously. If the request is
made over the telephone, the employer shall file the authorization not later than the 10th day after the date on
which the request is made.
THIS FORM MUST BE FILLED OUT COMPLETELY AND NOTARIZED TO COMPLY WITH THE LAW
- Telephone YES \ NO
9 / 1 " / ~i __ ____ ____
Date of Request ~ ( ust Circle One)
Signature
1. _Paula Rector~Tax Assessor-Collector
Requester's Full Name and Title
2. 74-6001494
Federal Tax I.D. Number
3 Kerr County __ Yv-_--Y
Employer's Full Name
700 Main St.
4.
Street Address
Kerrville Tx_ ________ 78028
City
State
Zip
5. ___-9 / 18 / 91 ---------- ______
Date of Application ~N
Signatur,Q,
6. ~~.tsV~~nne~Hank~-------------
Print or Type Applicant's Full Name
7, --449 ----_--23 _ 5471
-- -------------
Social Security Number
g. 325 George Court
-- - ------- --------
Street Address
Kerrville Tx. 78028
AP~~~GANT HAS NOT~,IM~~ ~ ~ ~ zip -
MORE GENERAL-~N~~' .
WEEKLY G~ty1PENSAI'tUN yVAS PA14
IF REQUESTED BY PHONE THIS FORM MUST BE RECE~A.~THtt~f'`70 'SAYS tN THE
COMMISSION'S AUSTIN OFFICE. ~'~°''"''~~*
r r r r w r r r r w w r r r r: r• r r r r• r w r w r a r r••• r r r•• r r r r r f•• r r r f r r r• r r r• r r r r••• r r r r r: r r r r r
STATE OF TEXAS
COUNTY OF KERR
SWORN

D SUBSCRIBED
// ~ ~
Signature of Notary Public
My Commission Expires:
R-12 (Rev. 4-90)
CK-06
Printed Name of Notary
(Seal)
~,r'~w+'1r~ THI~A SOVII,
.(~~, Notauy Publk, State ot'TexAs
\~ ~~ 1Ny Co~nmte9lon Ezpltts
'~~ JA}VUAKY 9. 1995
BEFORE ME THIS 1~'~day of o-,~- , 19 ~,~.
•9EP ~ 9 199 ~}
i ~
TIDt~a '
YYORKfry'
~ ~~~ 1 _ ~r
ORDER N0. 20609
Approval of Hiring Patsy
IAnnell Hanks in the Kezx',
County Tax/Assessors' O~~a.ce
October 15, 1991
Vol S, Page 440