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Free form template · Word

Salary Review Form

A salary review form captures why an individual employee's pay is being reviewed, the facts considered and the outcome recommended. It is used when a review is triggered by an event such as an expanded role, an employee request or a confirmation, rather than only the annual cycle.

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Preview of the form

[Highlighted] = fill in
[Company Logo][Company Name]

SALARY REVIEW FORM

Review No.:
[Reference Number]
Date:
[Date]

Section 1 – Employee Details

Employee Name[Employee Name]
Employee ID[Employee ID]
Designation[Designation]
Department[Department]
Date of Joining[Date of Joining]
Reporting Manager[Reporting Manager]

Section 2 – Reason for Review

  • Employee request
  • Confirmation after probation
  • Increase in role scope
  • Internal pay parity concern
  • Market / retention concern
  • Other: [Specify]

Section 3 – Current Pay Position

Current Annual CTC: ₹ [CTC]
Current Monthly Basic: ₹ [Basic Salary]
Date of Last Revision[DD/MM/YYYY]
Last Revision %[x]%
Grade / Band[Grade]
Band Minimum – Midpoint – Maximum: ₹ [Amount] – [Amount] – [Amount]

Section 4 – Assessment

Changes in responsibilities since last review[Details]
Latest performance rating[Rating]
Pay of peers in same role and grade (range): ₹ [Amount] – [Amount]
Market reference, if any[Source and range]

Section 5 – Recommendation

Outcome: Revision approved / No change / Review at next cycle / Other
Proposed CTC: ₹ [Amount] ([x]% change)
Effective Date[DD/MM/YYYY]
Reasons[Details]
Outcome communicated to employee on[DD/MM/YYYY] by [Name]

Declaration: The reviewers confirm that this assessment has been made on the basis of role, performance, internal parity and approved policy, without regard to any factor not related to work.

Reporting Manager
[Reporting Manager]
Date: [Date]
HR
[HR Name]
Date: [Date]
Approver
[Authorised Signatory]
Date: [Date]

What this template includes

  • Reason for review, so the trigger is documented
  • Current pay and date of last revision
  • Changes in role scope since the last review
  • Internal peer and band position check
  • Recommended outcome, including "no change" with reasons
  • Employee communication record

When to use it

  • An employee formally requests a salary review
  • Responsibilities have grown significantly without a change in title
  • Pay is reviewed at the end of probation or on confirmation
  • A manager flags that pay has fallen behind internal peers

How to customise this template

  1. 1List the review triggers your policy recognises
  2. 2Add your grade and band names to the band check section
  3. 3Include a section for variable pay if relevant
  4. 4Set the approval chain per your delegation matrix
  5. 5Keep the completed form in the employee's personnel file

HR tips

  • Document the outcome even when no revision is approved
  • Base the review on facts about role and performance, not on how hard the employee negotiates
  • Respond to an employee's request within a stated time frame
  • Keep the form confidential and share only with approvers

This template is a starting point only. Review it against applicable labour laws, state rules, your standing orders and compensation policy, and with a legal adviser where needed.

For HR & hiring managers

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Frequently asked questions

What is the difference between a salary review and an increment?+

A salary review is the process of assessing whether pay should change; an increment is one possible outcome. A review can also end with no change or a non-salary action.

Can an employee ask for a salary review outside the appraisal cycle?+

Yes, if company policy allows. HR should record the request on this form and respond after reviewing role scope, performance and market data.

How often should salaries be reviewed?+

Most companies review salaries once a year, with off-cycle reviews for promotions, role changes or retention cases as per policy.