Current Staff Action

Current Staff Action
The purpose of this form is to request a change in pay or schedule for your worker. If you would like to change a worker's job code or salary grade, please email the Executive Office Shared Services for guidance. If you have any questions, do not hesitate to contact us.
SECTION 1: Worker Details
Worker Name

First Name Last Name
UW Employee ID
Type of Change *

Temporary Adjustment of Rate of Pay Permanent Adjustment of Rate of Pay Adjustment for Existing Temporary Appointment Edit Weekly Hours/FTE/Schedule

Temporary Adjustment of Pay
Select the type of Temporary Adjustment of Rate of Pay

Temporary Pay Increase (TPI) Administrative Supplement (ADS) Mobile Service Agreement (MSA)
A Mobile Service Agreement requires an agreement form to be completed. Please complete the form found here: https://finance.uw.edu/ps/mobile-device-guidelines and attach it to this jot form.
Current Monthly Salary Rate *
Monthly TPI/ADS/MSA Amount *
Effective Start Date *

Month Day Year
Date
Effective End Date

Month Day Year
Date

Adjustment for Existing Temporary Appointment
Select an Employment Type

Professional Staff Temporary Position (PSTP) Classified Fixed Duration UW Student Hourly PSTP/Fixed Duration Hourly UTemp
Current Monthly Salary/Hourly Rate
Proposed Monthly Salary/Hourly Rate
Current Weekly Hours
Proposed Weekly Hours
Current End Date *

Month Day Year
Date
Proposed End Date *

Month Day Year
Date

SECTION 2: Change Justification
Which member of the Executive Shared Services team did you discuss this change with? *

Kim Dinh Maria MacGregor
Provide detailed justification for the proposed action and notes for the unit approver. *
Upload any supporting documentation for your request.

Upload Files

Cancel of

SECTION 3: Change Approval
Prepared by
First & Last Name
Preparer's Email *
example @uw.edu
If you are unsure, please view the Approval Flow Chart to confirm your Unit Approver so that this form can be routed correctly.
Unit Approver *
First & Last Name
Unit Approver Email *
example@uw.edu

SECTION 1: Worker Details