Department of Human Resources & Equal Opportunity

Salary Augmentation Request Form

CONTACT UMD HR PRIOR TO COMPLETING THIS FORM

No Civil Service employee shall receive an augmentation until there is approval from UMD HR.

To submit a request for an augmentation, fill in the information below and click the "Send it" button.

*Name of employee to receive increase/augmentation
*Empl ID of employee to receive increase/augmentation
*Department name
*Job Code Number
*Working Job Title
*Percentage of Appointment
*Total hours per week
* Current pay rate, hourly
*Requested pay/augmentation rate
*Begin Date
End Date (for augmentation only)
*Supervisor's Name
*Supervisor's Empl ID#
*Supervisor's Telephone Number
*Supervisor's e-mail address(____@d.umn.edu)

*Reason for Augmentation (Be Specific)


*Current Job Duties (Include Percentages)


*New Job Duties (Include Percentages)

Mark with asterisk which duties are out of class

*Contract/Rule Book/Policy that applies to request


*Article or rule that applies to request

*What is your first and last name?
*What is your campus telephone number?
*What is your complete email address?(____@d.umn.edu)
*Contact person's first and last name
*Contact person's telephone number
*Contact person's complete e-mail address(____@d.umn.edu)
*Department campus address

*Approvals

Comments

*REQUIRED FIELD---NEED TO BE FILLED OUT BEFORE SENDING

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Questions about the pay increase/augmentation request: (218) 726-6520

Questions about the website: (218) 726-7822