Change of Pay Rate
Date of form filling
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Month
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Day
Year
Date
Person Filling in this form:
First Name
Last Name
Email of person filling in this form:
example@example.com
Name of Employee being given a raise:
*
Location of employee at present date:
Please Select
JP Super Kitchen
JP-Corporate
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JP1 - 70 E.1st
JP3 - 1050 3rd ave
JP4 - 250 Mott St.
JP5 - 122 Greenwich Ave.
JP6 - 201 E.10th
JP7 - 156 Prince St.
JP8 - 144 North 8th St., Brooklyn
JP9 - 73 West 82nd St
JP10 - 1296 Madison Ave
JP11 - 1 W. 22nd St.
JP12 - 105 Rivington St.
JP13 - 93 Main St., Southampton
JP14 - 415 Greenwich St.
JP15 - 239 Columbus Ave.
JP16 - 65 W. 55th St.
JP17 - 2486 Main St, Bridgehampton
JP18 - 125 W. 41st St.
JP19 - 83 Murray St.
JP21 - 360 Greenwich Ave. (CT)
JP22 - 124 Montague St., Brooklyn
JP23 - 1474 3rd Ave
JP24 - 375 Hudson St.
JP25 - 830 3rd Ave
JP26 - 420 Park Ave South, Gansevoort
JP27 - 151 W 34th St., Macy’s
JP28 - 350 Amsterdam Ave.
JP29 - 630 9th Ave.
JP31 - 625 Madison Ave.
JP32 - 207 7th Ave.
JP33 - Grand Central
JP34 - 55 Main Street
JP35 - 1100 Lexington Ave.
JP36 - Rockefeller Center
JP37 - Empire State Building
JP40 - 330 w 34th st
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JPAD1 - Adidas NYC Flagship
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JPBoston1 - 33 Boylston, Chestnut Hill
JPBoston2 - 500 Boylston, Boston
JPBoston3 - 101 Seaport, Boston
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JPDC1 - Union Station
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JPWA01 - U Village Seattle
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WF01 - 113 Flatbush Ave. Brooklyn, NY
WF02 - Bridgewater, NJ
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JPLV1 - Bellagio Hotel, Las Vegas
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EQ01 - 92nd St. and 3rd Ave
EQ02 - W 76th St. and Amsterdam
EQ03 - Summit, NJ
EQ04 - Paramus, NJ
EQ05 - 54 Murray St.
EQ06 - PrintHouse
EQ07 - Greenwich, CT
EQ08 - Brookfield Place
EQ09 - 250 E 54TH St. and 2nd Ave
EQ10 - Columbus Circle
EQ11 - E 74th St. and 2nd ave
EQ12 - W 17th St. and 10th Ave
EQ13 - 1 Park Ave and E 33rd St.
EQ14 - 203 E 85TH St. and 3rd Ave
EQ15 - 1633 Broadway and 50th St.
EQ16 - DUMBO
EQ17 - 10 E 53rd St. and Madison
EQ18 - GrayBar
EQ19 - 45 Wall St. and William St.
EQ20 - 897 Broadway and 19th St.
EQ21 - 670 Broadway and Bond St.
EQ22 - 315 Park Ave S and 24th St.
EQ23 - Brooklyn Heights
EQ24 - 2465 Broadway and W 92nd St.
EQ25 - Mamaroneck
EQ26 - Armonk
EQ27 - Williamsburg
EQ28 - 521 5th Ave.
EQ29 - Dartmouth St., Boston
EQ30 - Franklin St., Boston
EQ32 - Darien, CT
EQ33 - Woodbury, NY
EQ34 - Roslyn, NY
EQ35 - Great Neck, NY
EQ36 - Seaport, Boston
EQ39 - 196 Orchard St.
EQ41 - Southport, CT
EQ42 - HudsonYards
EQ43 - 330 E 61st Street
EQ44 - Greenwich
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SC01 - Hoboken, NJ
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SR01-
SR02- Bloomfield
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Effective Date of Increase:
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Month
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Day
Year
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Current Pay Rate $
*
Hourly, weekly, or annual?
Increased Pay Rate $
*
Hourly, weekly, or annual?
Reason for pay increase. (check all that apply.)
*
Performance Review
Change of Position
Merit/ Additional Responsibility
Other
Please add a comment:
*
Supervisor Signature
*
Date
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Year
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AM/PM Option
Area Manager Signature
*
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AM/PM Option
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