Pay Adjustment Request Form

Pay Adjustment Request Form

For All Adjustment Sources
    More than one may be selected.
  • Percentage and/or amount for all reasons combined; most reasons have a minimum %, some have a max: https://www.ohr.wisc.edu/docs/PayAdjustmentToolsMechanismsAmountMatrix.pdf
  • Date Format: MM slash DD slash YYYY
    Please note, the pay increase will not be effective until the office of human resources approves the pay increase. Pay increases are not eligible for retroactive dates. Please do not promise employees pay increases until you know this has been submitted and approved by OHR and the date has been confirmed.
  • Note: once approved the department manager/HR manager will enter into the HR system, there will be additional information needed such as: full justification, performance management activity date, etc.