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PayrollChangeForm
Payroll Change Form
Employee Name
*
First
Last
Employee Email
*
Change Requested
*
New Employee
Salary Increase
Promotion
Transfer
Termination
Other
Tranferring from:
Enter the transferring employees current department and/or job title.
Transferring to:
Enter transferring employee's new department or title.
Effective Date
MM slash DD slash YYYY
Salary: ex. $17/hr or $35,000 or $0.25/hr increase
Exempt?
Yes
No
Reason for termination:
Voluntary?
Yes
No
If "Other," please explain
Form Submitted by:
*
Choose One
Amber Nelson
Bethany Walton
Caleb Alford
Anne Smith
Submitter's Email
*
Choose One
anelson@arcaustin.org
bwalton@arcaustin.org
calford@arcaustin.org
Asmith@arcaustin.org
Upload documentation of offer
Max. file size: 2 MB.
Upload any additional stipends needed
Max. file size: 2 MB.
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