NameThis field is for validation purposes and should be left unchanged.Schedule & Pay RateOfficer Name* First Last Officer Email* Is this the officer's first schedule and pay rate, or is this a change to an existing schedule/ pay rate? First Change/ Update Is this a schedule change, a pay rate change, or both? Schedule Change Only Pay Rate Change Only Both Site/ PropertySite/ Property AddressShift ScheduleDayShift **Schedules are subject to change at supervisor discretion**Additional Site/ Property? YES NO Addl Site/ PropertyAddl Site/ Property AddressAddl Shift ScheduleDayShift Initial Hourly RateNew Hourly RateEffective Date* MM slash DD slash YYYY ** Please make first date of a pay period if possiblePOM Supervisor*Officer SignatureToday's Date* MM slash DD slash YYYY Δ