Employee Name:	Position #:	Effective Date:
SECTION 1 – Justification and Support
Complete ONLY those pay factors that will be considered for this pay decision proposal and provide appropriate justification. Refer to Policy and Procedure 8.3 Human Resources Compensation Management for definitions of pay factors. A current employee must meet or exceed performance standards to be eligible for a management-initiated increase.
Agency Business Need:
Duties and Responsibilities:
Performance:
Work Experience and Education:
Knowledge, Skills, Abilities (KSAs) and Competencies:
Training, Certification and Licensure:
Budget Implications:
Long-Term Impact:
Current Hourly Rate:	Proposed New Hourly Rate:
SECTION 2 – VDOF Approvals
Director/Regional Forester Name (Print)	Director/Regional Forester Signature	Date
Budget Officer Name (Print)	Budget Officer Signature	Date
Human Resources Director Name (Print)	Human Resources Director Signature	Date
Edward Zimmer
Deputy State Forester Name (Print)	Deputy State Forester Signature	Date