ࡱ> 685 bjbjT~T~ 466nn81LfE[[[[TV[[4j[[[gx@0LDLn w: Off-Term Time and Effort Reporting Form All funding agencies require effort certifications for all University employees whose salaries are charged to sponsored programs. In order for the University to comply with this time and effort reporting requirement, each faculty member or professional staff employee working on a grant or contract needs to complete this form by the end of each semester. Additionally, whenever any salary is charged or committed to a sponsor, the University needs to keep accurate records of this obligation, so the employee needs to complete this form. Please send the completed form to the Office of Sponsored Programs and Research Activities (OSPRA). If you have any questions, please contact Cate Caldwell at 993-1544 or  HYPERLINK "mailto:caldwecr@udmercy.edu" caldwecr@udmercy.edu. Name: __________________________ Department: _________________________ Please specify term/s_________________________________________________________ Provide a breakdown of your responsibilities for your off-term semester. The total must not exceed 100% of your regular workload. Please use additional sheets as necessary. Actual Effort: % Teaching and teaching-related activities ____________ Administrative/Clinical/Unsponsored Research (Unrestricted) ____________ Grant [Account # ______________________ ] ____________ Grant [Account # ______________________ ] ____________ app Cost Share [Restricted Fund # _______________ ] ____________ app Cost Share [Restricted Fund # _______________ ] ____________ Other (please specify) ______________________ ____________ TOTAL _______ I certify that the information provided is correct. Employee Signature ____________________________________ Date ___________ Confirming Signature ___________________________________ Date ___________  Cost share refers to a portion of a sponsored project that is contributed by the university but not reimbursed by the sponsor.  Total effort for the off-term must never exceed 100%. Total effort for an off-term semester must equal 100% or less.      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