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Salary Change Request Form
(In-range or Augmentation)


CONTACT UMD HR PRIOR TO MAKING A COMMITMENT TO THE EMPLOYEE OR COMPLETING THIS FORM

No non-academic employee shall receive an In-range or augmentation until there is approval from UMD HR & EO.
To submit a request for an augmentation, fill in the information below and click the "Send it" button.

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


*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 Phone Number
*Supervisor's e-mail(____@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


*Contact person's first and last name
*Contact person's phone number
*Contact person's complete e-mail address(____@d.umn.edu)
*Department campus address

*Approvals

Comments

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Questions about the pay increase/augmentation request: (218) 726-7912


© 2014 University of Minnesota Duluth
The University of Minnesota is an equal opportunity educator and employer.
Last modified on 03/17/14 08:15 AM
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