Wage Increase Form
Employee Name
*
First Name
Last Name
Department
Effective date of rate change - 1st or 16th of month -
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Nowsta rates may change later but that will not affect wage paid
Role for rate change
*
Current Pay Rate
*
New Pay Rate
*
Comments
Manager Approval
*
First Name
Last Name
Signature
*
Today's Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Office Use Only
Manager Approved
Yes
No
Manager approval date
Approved by Manager
Initial
Date
Completed on  Â
Date
   by
blank
effective  Â
Date
  Â
Should be Empty: