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. ______________________ Date ____________________
Personnel Dept. ______________________ Date ____________________