Employee Pay Fixation Checklist
Complete this checklist to review and document an employee pay fixation request for HR/payroll processing.
Employee Full Name
*
First Name
Last Name
Employee Code
*
Department
*
Please Select
Human Resources
Finance
IT
Operations
Sales
Marketing
Other
Job Title
*
Grade/Band
*
Please Select
Band 1
Band 2
Band 3
Band 4
Band 5
Other
Location
*
Current Pay Details
*
Proposed Pay Details
*
Effective Date of Pay Fixation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Pay Fixation
*
Please Select
Promotion
Annual Increment
Correction
Policy Change
Market Adjustment
Other
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of
Approval Status
*
Pending
Approved
Rejected
Reviewer Notes
Submit Checklist
Should be Empty: