Employee Change Form (ECF) - Pay/Position (2023)

* Employee Name

Employee ID

* Requestor Name

Requestor Title

Reason for change(s)

Effective Date of Change (Must be a Sunday) +

Compensation

Current Pay Grade

New Pay Grade

Current Pay Rate

New Pay Rate

% Increase

0.00

Current Per diem

New Per diem

Current Truck pay

New Truck pay

Current Position / Title

New Position / Title

Current Supervisor

New Supervisor

Current Department

New Department

Current Work Status

New Work Status

Form submitted by? 🛈

Other Email Address 🛈

Clicking the "Submit" button will send this request to the Payroll Department & and a copy will be sent to the requestor's email address.