Salary Increase Forms Exhibit 3-41

AUTHORIZATION FOR SALARY CHANGE

Employee Date of Hire / /

Current Position Current Job Grade

Reason For Change:

Annual Review Promotion to Job Grade
New Position
Other Department Name

Current Salary $ Date of Last Salary Review / / Date of Last Evaluation / /

Performance Rating: Exceptional Commendable Needs Improvement Unacceptable

Current Quartile: First Second Third Fourth

Increase Amount:
Merit Increase Promotion Increase
Annual merit increase = . % . %

. % annual merit increase pro-rated over months = . %

Special Salary Adjustment Amount of Adjustment

Γ To minimum of promoted salary range after promotion increase $
Γ To minimum of current salary range (prior to increase) $
Γ To annual pay prior to increase $
Γ Other $

New Salary $ Total Increase . % Effective Date / /

Comments:

Immediate Manager: Human Resources:

Date Date

Department Manager: President:

Date Date

INSTRUCTIONS
Salary Increase Forms Exhibit 3-41 (continued)

1. Complete the top portion of the form with all of the information requested on each employee receiving a
salary review.
2. Increase Amount
All percentages should be rounded to one decimal point (i.e., 3.44% = 3.4%; 3.45% = 3.5%.)
A.. Annual merit increase - the 12 month increase recommendation from the Merit Increase Matrix
B. Pro-rated merit increase - the increase recommendation which covers a period of less than 12
months or greater than 12 months. Only full months of service will be used in the calculation. Credit
is received for an entire month only when the new salary review effective day is equivalent to or after
the last salary review effective day. The annual increase amount is determined from the Merit Increase
Matrix and is prorated using the following formula:
Annual Increase %
X # Months = Annual pro-rated increase percent
12

3. Promotion Increase
5% should be filled in for all promotions. The promotion increase is applied prior to the merit increase in
calculating the new salary. See 4.A. below prior to calculating the merit increase.

4. Special Salary Adjustments

A. To minimum of promoted salary range after promotion increase. If, after calculating the
promotion increase, the salary is below the minimum of the new range, indicate the dollar amount
required to bring the salary to the new minimum before the merit increase is applied.
B. To minimum of current salary range (prior to increase). If an employee’s salary falls below the
minimum of the current salary range, indicate the dollar amount the salary will be adjusted before the
merit increase is applied, if any.
C. To annual pay prior to increase. If applicable, indicate the dollar amount the salary will be adjusted
before the merit increase is applied. General salary adjustments usually occur to offset potential
compression between employee salaries.
5. New Salary
The current salary (or adjusted salary if any in 4. above apply) plus the percent salary increase
recommended, rounded up to the next full dollar (i.e., $34,503.01 - $34,504.)
6. Total Increase

The percent difference between the current salary and new salary, which takes all recommended increases
into account.
7. Effective Date
The first day the new salary begins. This date should coincide with the first day of a bi-weekly pay period.
8. Signatures
All signatures are required. The salary approval will be communicated by Human Resources to the
immediate manager, who may then communicate the salary information to the employee.