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College of Physical and Mathematical Sciences Summer Salary/Supplemental Pay Request Form Date: Name of Principal Investigator People Soft ID: Please circle: 9 month or 12 month appointment Are you requesting more than 2 months of Summer Salary? Dept: Annual Salary: Monthly Salary: * I would like to request to be paid from the following grant(s) and/or contract(s) for the time period listed below. * I will not be taking any vacation during this period of time. % of Time to be Charged to Project for this Period Account 1 2 3 4 5 6 7 Agency Start Date End Date # Months Amt of Pay If you need to make a change to your funding source please notify the College Business Office. Changes to funding sources after payment is discouraged, but can be processed up to 120 days after salary has posted. Keep in Mind: July and August Summer Salary Requests will receive retroactive increases based on % of approved legislative increase Plan your requests for July and August accordingly. I understand that I will need to certify in my TEARS report that my effort was consistent. to the amount of time that will be charged to indicated sponsored research projects for this period. Principal Investigator Date College Business Office Date Department Head Date *Dean Date FORM DUE TO Business Office on the first working day of the month for which you are requesting summer salary. If you have questions concerning this form contact: Ann Hunt at 513-1000 for 5-Ledger funded summer salary Joyce Stevens at 513-2089 for all other funding sources

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