Rate Change Request

Technician Rate Change Request

Technician

Technician name

Role or level (optional)

Rate change

Current rate

$ /hr

Proposed rate

$ /hr

Effective date

Usually the start of the next pay period.

Last increase (optional)

Approvers ask this first. Leave blank if you don't know.

Reason for the increase

Make the case

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Submitted by

Your name

Yearly figures assume 2,080 hours and are an estimate for comparison, not a payroll calculation.