Request for Annual Increase- Form

REQUEST FOR PAY INCREASE FORM

Annual Performance Review Cycle
Please utilize this form if you are requesting an increase for your team members per the annual performance year.
Date

MonthDayYear
Date
Employee Name

First NameLast Name
Manager requesting pay increase

First NameLast Name
Regional Manager*
Office Location
Position
Position type (ex: full-time/part-time)
Current hourly rate or salary?
Recommended hourly rate?
Last pay increase & amount?
Reason for increase

Performance Merit- increase (employee meets expectations)Performance Merit, HIGH PERFORMER- increase (employee exceeds expectations)High Potential (someone with the ability, engagement, and aspiration to rise and succeed in more critical or different roles within organization)Market AdjustmentInternal Equity AdjustmentRetention- employee is considered high risk & we want to keep in organizationEmployee requested increaseOther
Please provide as much detail below per the selection you made above (reason for increase) - ex: employee has taken additional responsibility, etc.:
Do you recommend employee for a pay increase?

YesNoNot at the rate they are requesting
Please upload copy of current employee performance review*

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You can still complete performance review for employee (even if they didn't complete their assessment) Cancelof
Comments
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REQUEST FOR PAY INCREASE FORM