PAY RATE CHANGE FORM by JeremyJenkinson

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                              PAY RATE CHANGE FORM


EMPLOYEE:

HIRE DATE: ___________________

CURRENT PAY RATE: $ ________________ HOURLY / SALARY (CIRCLE ONE)

PAY RATE TO: $_________________ HOURLY / SALARY (CIRCLE ONE)

EFFECTIVE DATE OF CHANGE: ________________

REASON FOR CHANGE: _______________________________________________________________________

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