SALARY RECOMMENDATION FORM
Employee Name _____________________________
I.D.# _____________________________ Location _____________________________
Department _____________________________
Current
Proposed
Title
________________________
________________________
Salary Grade Base Rate
________________________ ________________________
________________________ ________________________
Merit Amount
________________________
________________________
Promotion Amount ________________________ ________________________
Other Amount
________________________
________________________
Bonus
________________________
________________________ ________________________
Effective Date ________________________ Type of Proposed Increase:
[ ] New Hire
[ ] Merit
[ ] Promotion
[ ] Other ___________________
Date of Last Increase ______________________
Type of Last Increase:
[ ] New Hire
[ ] Merit
[ ] Promotion
[ ] Other ___________________
Explanation for Proposed Salary Increase __________________________________ __________________________________________________________________ __________________________________________________________________
Approvals:
Supervisor __________________________
Date ____________________
Manager ___________________________
Date ____________________
Div. Vice-Pres. ______________________ Personnel Dept. ______________________
Date ____________________ Date ____________________