Pay Raise Form Home / Employee Pay Raise Name* First Last Pin Job Title Manager* Is this a Department Change?*Select OneYesNoNew Department Hire Date MM slash DD slash YYYY Last Pay Increase Date MM slash DD slash YYYY Present Rate of PayNew Rate of PayEffective as of MM slash DD slash YYYY Evaluation/ReasonSigned by* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY CAPTCHA