Department of Human Resources & Equal Opportunity

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 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