iJRI7Ei't MCI. ~_id3t31
f1F~RRCiVf1L. OF HIRJ:IVb L5>il1EFZ R. GttRZi=t H:ii
C:Ot~11~1IESIOhJP_I?8' COLJI?"( pE=F'l71'Y
IN THE. COUN-FY CLERF'.' S OF=F` ICf:
On thi, the 8th drzy o'F ,7~..t.ly 1991, ~.ipon mc;tion made by
Commissioner Holekamp, seconded by Commissioner-~ Oehler, the
~_ourt unanimously approved 3-0-0 the I-iiriny of Lsthen• Ft.
a~ar:.a in {;he Co~_{n~t;y Clerk' O~F~rice, e~i=~Fe~tive J~.ily 1, 1'39.1 at
F'ay ~ronp 1L~, Etep 1, 416, 1'i?~.˘iN ar;rn_;all.y, 41,3<r:i.33 monthly,
ar~d ~F~S71.t:? semi-monthly.
COMMISSIONERS' COURT AGENDA REQUEST ~'~~~
• PI FASF F 1RNISH ON ORI INA AND'~FVFiJ OPI OF THI R 0 TAND D M NTS
;JO bG R[VIEW[D f)Y 11I[ COURT.
riAD[ bY: Patricia Dye OFFICE: xerr County Clerk
r1EETINGDATE: July a, 1991 TIME PREFERRED:
SUBJECT: (PLEASE BE SPECIFIC): Approval of Hiring Esther R. Garza effectivc
July 1, 1991 at a 15/1-annual salary $16,120-monthly $1,343.33. She is
replacing Tommie C. Huston as Commissioners' Court Deputy.
ESTIMATED LENGTFI OF PRESENTATION: 20 minutes
IF PERSONNEL MATTER -NAME OF EMPLOYEE: ~ Es h r' R. (.aroma
NAME OF PERSON ADDRESSING THE COURT: Patricia Dye
71me for submitting this request for Court to assure that the matter Is posted in
accordance with Article 6252=17 Is as fol lows:
• Meetings held on second Monday: 12:00 P. M. previous Wednesday
. Meetings held on Thursdays: 5:00 P. M. previous Thursday.
If preferable, Agenda Requests may be made on office stationery with the above
information attached.
TNIS REQUEST RECFlVED BY:
THIS REQUEST RECEIVED ON:
a?
AI! Agenda Requests will be screened by the County Judge's Office to determine
adequate Information has been prepared for the Court's formal consideration and action
time of Court meetings. Your cooperation will be appreciated and contribute towar~
your request being addressed at [he earliest opportunity.
,~~ ,.
Application For Employment
Follow inswctiona exactly. FU out the application form completely. >E items are not applicable, enter 'NA'.
Do not leave items blank. Reatmtes era accepted for any additional information they contain but not in piece of a
completed application. Ha attre to stgn the application after completion,
Current Ad ess (PO x, St. Apt . City, e, Zip) _ Home Phone (arts coda IfC number)
~ 0 S~ E E /a2 (n -
Permanent Address- differeat (PO.Bx, St, Apt .City, rate, Zip) Work/Day Phoae (acre code do number)
Type 4f Position Desired Data Available Minimum Acceptable Salary
h ila1- t
Work Status Desired Have you ever been discharged
Full Time [] Part-Time ^Seasonal by an emptoyu7 ^ Yes l$) No
if yes. explain:
!f position you are applying for required the operation of a motor vehicle, do you have a current Texas Drivels
License? ®Yes ^ No License Number: /?/ RS//~.~~
jDo you have relatives working for Kur Countyl If yes, give names, relationships, and department
^ Yes ®No employed
EDUCATIONAL RECORD
HIGHEST GRADE COMPLETED
^1^2^3174^5^607^8^9^ 10^111512
Did ou raduate from high achool/GED7 ®Yes ^ No
1f a degree or voeatioaal or college credits era required to meet minimum qualifications for a position you are
seekin a transcri t is re aired:
Name of School Location
Mo. Yr. Mo. Yr. Earned Yes N De rce/Certi(icate of Stud
Susi/Tech/Voc Schools '
~o0ege•Univertity Sem. Hra Graduated?
traduate Schools Sem. Hra. Graduated?
~K-02 An Equal Opportunity/Affirmative Action Employer
List any special course work (include the number of hours completed), training, or experience that qualifies
for the classification(s) for which you are applying. Also list memberships in irelevant professional
organizations:
List current licenses/certificates/registrations (indieata types and dates received)
Skil-s:
List special= skills and machines or office equipment you can use (adding machines, dictation equipment,
printing/graphic equipment. data processing etc)
00 ~~6 ~~~e u/~
Languages (List): _
Fair O Goad O Excellent I O Fair O Goad ~?xeelteat
Branch
Dates of
Are
Fatr O Good O Excellent
the Active Rescrvel
.OYMENI' RECORD; Thia information will ba the officlat record of your employment history and must
ately reflect all significant duties performed. You must provlda all the Iaformatioo requested In order fo
qualifications to be evaluated properly. Add additional sheets as needed.
Job
(mo/day/yr)
Through (mo/day/yr) Final Salary
Phone (uea code <<c number)
i.s-,~S7-~Lf/
St, Apt
and Job types
Reason
supervlsad by yow
(e.g. 3 managers, 2 tcchnieians, 2 clerks):
1~i .~ ~ufi~-E. c~u2~~*q -a~LC' ~`c"`°'' /G1.L~~ft~D-~i .qtr", ,~.4~cY
Glir~K //// t'-Lc J'~j~~//~f~~g~Q~/(/~~-~/~L ~uiux.t~cn %%~z~~r"~
///. .l~L Ll~` ~^+v.^~' lJ ~. /1Y'~ iii. ./~i/u, /~'~ .WA/i.Q- //~~~'i C~

or a
Job Title // From (nto/day/yr) Through (mo/day/yr) Final Salary
~Pt~U~ (J~in,Utt/ ~ arPK ~S ocr
Name o~Organizati~J[ Address~iaO.Bx, St. Apt, City, Stale, Zip) Phone (arcs code & number)
...+ ru~r w rare - .,me u arc-ume a roximate number of nears er week:
Name of Supervisor Title of S rvisor
~~~5 Nuo~.~ ~/ F 1~,cu~u
Number and job types of employees aupervlscd by you, it any (e.g. 3 managers, 2 iec ~cians, 2 clerks):
Reason for Leaving
': /JiR-lN K FyYtLG[c ~E~{,T~[C{@r~i~vs- /
`~2~/!tvrur~' "Ll11su:: ~Eh.~'r.~-E=EL
oL ~ p ,
~... ~ .,
y , ,~ 1 5'
Job Title o Fr~ln (mo/day/yr) Through (mo/day/yr) Final Satary
S r
Name of Organirstioa Address (PO.$x, St, Apt ,City, State, Zip) Phone (area code & number)
Fail- Part -Time If art•time a roximate number of hours er week:
Name of Supervisor Title of Supervisor
Number and job types of employee supervised by you, If. any (e.g. 3 managers, 2 technicians, 2 clerks):
Reason for Leaving

PERSONAL DATA:
Do you have any existing physical or medical conditions or disabilities that would Interfere with our
ability to perform the Job tot which you have applied for? ^ Yes ~No
If yes, please explaia: ~~ _~.________~~~__~_~._~`_____~~~__
Have you ever filed a Workers' Compensation claim?
If yea, piease explain: ~_,.,_Y,__~_~~_-
^ Yes ~No
Have you ever been convicted of a crime?
If yes, please explaia: ____,
^ Yes ~No

EAIPLOI'61ENT RECORD CONTINt~ED Pagc 4 of 4
Plcasc list 3 names of individuals willing to provide character or professional references:
Name Addreaa Telephone M ~ Relationship
Please read the following statements carefully and tadicate your uaderstaading sad acceptance by tigaing your
same in the space indicated.
1. I Certify that the foregoing statements as well as those on any attachment(s) to this form are to the best of
my knowledge true and cortect and that they are given of my own free will.
2. I understand that any misstatement (s) or omission(s) of material facts will constitute grounds for
unfavorable consideration or dismissal from employment.
3. I understand that former employers and educational institutions may ba Contacted for employment and
educational information. ~
4. I understand that Kert County may contact my current employer for employment information before
making a binding o[fer of employment.
S. 1 understand that if employed, I wilt serve an initial probationary period.
6. I understand that any omissions of material facts or any false IntormaJon that I give to obtain past.
prescnt, or future county (KERR) bcncfits may result in unfavorable consideration or dismissal from
employment.
7. I understand that before I tan be employed by the County, I must show proof of identity and U.S.
citizenship or authorization to work in the U.S. (e.g. drIver'a license, and either a social security card or
a birth Certificate). ~7q'~ ~~--~~~
APPLICATION MUST H8 SIONED: SCE-t;~ ~ -- _-Z- ~~ ~/ _
SIGNATURE-APPLICANT DATE

TEXAS WORKERS' COMPENSATION COMMISSION
200 East Riverside, Austin, Texas 78704-1287
(512) 448-7934
WAIVER OF CONFIDENTIALITY
1 understand all information in my worker's compensation file(s) is confidential under the Texas Worker's
Compensation Act. However, f 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 inlormation 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) The employer must obtain wr)tien authorization from the applicant belore making the
request. (e) II the request is made in writing, the authorization shall be tiled simultaneously. Ii the request is
made over the telephone, the employer shall file the authorization not later than the 10th day alter 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
July 1, 1991
Date e7~uest (Must Circle Onef~
Signature
t, ----Patricia Louise Dye
-----------------------
Requester's Fuil Name and Title
2. 74.6001494
Federal Tax I.D. Number
Patricia Louise Dye
3.
Employer's Fufl Name
4, 700 Main Street
Street Address
g. July 1, 1991
------------------------------
ate of A
S ignature ppkcation~
Print or Type Applicant's Full Name
7. -°---d62-_.Ori--- --~~-------
Soeial Security Number
8• ___ F+n4 Stgsnhon Sf .
Street Address
-__--Kerrville, _T_X__78028-5389
City State --------Zip -
---- KPi-r'vi 1 ~ p. _-13C.--Z~----------
City State Zip
IF REQUESTED BY PHONE THIS FORM MUST BE RECEIVED WITHIN 10 DAYS IN THE
COMMISSION'S AUSTIN OFFICE.
STATE OF TEXAS §
C.OUNIY OF KERB
/ ~nSW~'ORN AND SUBSCRIBED TO BEFORE ME THIS 1 day of JAY , 1 g 91
~/ /~~ ~ PATRICIA DYE
---- --- _
---------- ------------------------------
Signature of Printed Name ~~
PATRTCIA DYE, COUNTY CLERFC IN AND FOR KERB CO. (Seal) PATRICLA DYE, COUNTY CLERK IN AND FOR
My Commission Expires: 12-31-1994 KERB CO[TNTY, KERRVILLE, ~{p,,g
R-12 (Rev. 4-90)
CK-06
KERB COUNTY MEDICAL REPORT
(APPLICANT'S COPY)
I, Paul H. Kocay a licensed physician, hereby certify that
have on this date, medically examined Esther R. Garza and
find Sher to be in sound physical condition and free from any physical defects that
could prevent or adversely affect the performance of ~/her duties as
6 ~~~ ~ ------
Date
Signature of Physician
G-3527
Physician's License Number
PLEASE GIVE THIS PORTION TO APPLICANT TO BE RETURNED TO KERR COUNTY DEPARTMENT
HEAD.
CK-05
ORDER N0. 20381
APPROVAL OF HIRING ESTHER
R. GARZA AS COMMISSIONERS'
COURT DEPUTY IN THE COUNTY
CLERK'S OFFICE
July 8, 1991
Voliune S, Page 310