Employee Change Request (Role and/or Pay)

1
Company Name* This field is required.Enter the official name of the company. This helps HR identify the correct entity.
2
Requestor First Name* This field is required.
3
Requestor Email Address* This field is required.Enter a valid email address for the requestor. HR will use this to contact for clarifications.
example@example.com
4
Employee Full Name
First Name
Last Name
5
Employee Email Address* This field is required.Provide the employee's official email address.
example@example.com
6
Current Job Title* This field is required.Current job title held by the employee.
7
Current Department/Team* This field is required.Department or team where the employee currently works.
8
Current Work Location* This field is required.Select the employee's current work location or arrangement.
Please Select
Please Select
Remote (specify city/state below)
Hybrid (specify city/state below)
Onsite (specify city/state below)
9
Current Work Location Details (City/State)* This field is required.Specify the city and state for the current work location if remote or hybrid.
10
Current Manager Full Name* This field is required.We need to know who this team member reports to.
11
Current Manager Email Address* This field is required.Email address of the employee's current manager.
example@example.com
12
Type of Change Requested (select all that apply)* This field is required.Select all types of changes requested for the employee.
Promotion
Demotion
Lateral Transfer/Team Change
Title Change Only (no duty change)
Compensation Change (base pay)
Bonus/Commission Plan Change
Pay Type Change (hourly ↔ salary)
Employment Status Change (Exempt or Non-Exempt Review)
Work Arrangement Change
Schedule/Shift Change
Other (please describe below)
13
If 'Other', please describe the change requested.* This field is required.If 'Other' is selected above, please describe the requested change in detail.
14
Effective Date of Change* This field is required.Date when the requested change should take effect.
Date
Month
Day
Year
15
Reason for Change* This field is required.Reason for requesting the change.
Please Select
Please Select
Business Need
Employee Request
Market Adjustment
Performance
Organizational Change
Other
16
Notes / Additional ContextAdditional notes or context related to the change request.
17
New Job Title* This field is required.New job title if changing roles.
18
New Department/Team* This field is required.New department or team assignment.
19
New Manager Full Name* This field is required.Full name of the new manager.
20
New Manager Email Address* This field is required.Email address of the new manager.
example@example.com
21
Updated Responsibilities Summary* This field is required.Summary of updated responsibilities for the employee.
22
New Work Location / Arrangement* This field is required.New work location or arrangement for the employee.
Please Select
Please Select
Remote
Hybrid
Onsite
23
Exempt Status* This field is required.Exempt status of the employee under labor laws.
Please Select
Please Select
Exempt
Non-Exempt
24
Is a background check required for this change?* This field is required.Indicate if a background check is required for this change.
Yes
No
25
Type of Background Check (if required)* This field is required.Type of background check required, if applicable.
Please Select
Please Select
Standard Employment
Criminal History
Education Verification
Other
26
Please confirm background check authorization has been obtained.* This field is required.Confirm if background check authorization has been obtained.
Yes, authorization obtained
No, pending authorization
No, I would like BizLion HQ to send this for me
27
Pay Type* This field is required.Type of pay (hourly or salary).
Please Select
Please Select
Hourly
Salary
28
New Base Pay Amount (USD)* This field is required.New base pay amount in USD.
29
Pay Frequency* This field is required.Frequency of pay payments.
Please Select
Please Select
Weekly
Bi-Weekly
Semi-Monthly
Monthly
30
Bonus Eligibility* This field is required.Indicate if the employee is eligible for bonuses.
Eligible
Not Eligible
31
Commission Plan Details (if applicable)Details of the commission plan, if applicable.
32
One-time Payment Details (if applicable)Details of any one-time payments, if applicable.
33
Upload Supporting DocumentsUpload any supporting documents for the change request. (new job descriptions, performance reviews, etc.)
Drag and drop files here
Select files to upload
Max. file size: 10.0MB
Cancelof
34
Special Instructions / Delivery NotesSpecial instructions or delivery notes for the change request.
Should be Empty: