Salary Increase/Payment Authorization Form
(Return to Compensation-HR-Briarcliff Campus)
CONFIDENTIAL
Employee Name:
Department:
Employee's Pace I.D.
Date Employed:
Current Information ("From")
Proposed New ("To")
Base Salary:
Job Title:
Effective Date:
Stipends and Other Non-Base Payments
Amount of payment (non-base):
Check one:
Pay Period Start:
one-time
series of payments
Pay Period End:
Basis for Change:
Promotion*
Annual
Other*
Note: * Job description must be attached if title and/or duties are changing.
Circumstances/Comments Regarding Recommendation:
Budget to be charged:
Index:
Orgn:
Acct:
Budget Rep. Confirmation of Available funds:
Recommended by:
Date:
Dean/VP Approval:
Date:
Human Resources:
Date:
Position #:
*50*
Action:
Check if announceable:
Code:
Last revised on 02/28/2005