CLASSIFICATION REVIEW REQUEST
NOTE: Supervisors should send a copy of the attached PIQ electronically via e-mail to Doug.Kennedy@southernwv.edu
or susan.ross@southernwv.edu
December 1, 2015
Incumbent Name: _________________________________________________________________________________________
Current Job Title: _______________________________________________________ Pay Grade: _______________________
Department/Unit: ______________________________________ Immediate Supervisor: _______________________________
Requested by: Employee Supervisor Other, explain _________________________________________________
Identify the area of the PIQ that has changed since the last review, select the appropriate Job Factor(s):
I Knowledge VIII External Contacts
II Experience IX Direct Supervision
III Complexity & Problem Solving X Indirect Supervision
IV Freedom of Action XI Physical Coordination
V Scope & Effect XII Working Conditions
VI Breadth of Responsibility XIII Physical Demands
VII Intrasystems Contacts
On a separate page, provide an explanation describing the change(s) for each Job Factor identified above.
Briefly describe reason(s) for requesting this classification review:
(If more space is needed, attached additional pages)
________________________________________ _____________________________________
Employee Signature Date Supervisor Signature Date
TO BE COMPLETED BY HUMAN RESOURCES
Classification Review Action:
Current Base Salary: $_______________________ (Excludes Increment) FTE: __________ Fund: ___________Pos# _______
Current Job Title: ________________________________________Current Title Code: ______________Pay Grade_______
Proposed Job Title: ________________________________________New Title Code: ____________ New Pay Grade: ______
Proposed Effective Date: ___________________________________
Proposed Base Salary: $ _______________ (Excludes Increment) FTE: _______ Fund: _________ Pos #: ______________
Comments:
____________________________________________ ________________________________________________
Director of Human Resources Date Vice President of Finance & Administration Date
____________________________________________ ________________________________________________
Vice President of Unit Date President Date
