Simply replace the unfilled areas such as "[]" and "[date]" with your information.
Dear [name],
I wanted to draw attention to my accomplishments and responsibilities and how I am an asset to our team each and every day. I'm very positive about my job in this organization, and would like to discuss how to increase my contribution, and the reward I receive.
My salary has not been increased for [# of months/years]. The cost of living is always increasing and thus money doesn't go as far as it once did. Investing in loyal employees such as myself is an investment in this company.
Thank you for your time and consideration in this matter.
Sincerely,