RUTGERS BIOMEDICAL AND HEALTH SCIENCES (RBHS)

EXTRAMURAL SUPPORT INCENTIVE PROGRAM - FY2017

FOR FACULTY IN THE AAUP-BHSNJ NEGOTIATIONS UNIT

PART A – TO BE COMPLETED BY FACULTY MEMBER

I certify that I have received salary support from the attached external research grant(s) or extramural sponsored research award(s):

Title of Research Award* / Acct # / Amt of Salary Support ($) from grant / Date Submitted / If Grant Submitted Before 11/15/15, Which Plan Was Previously Selected (Old/New)

Use extra sheet if needed. Was extra sheet required? Yes _____ or No _____ (check one)

*Funding related to clinical and service contracts, unrelated to research, are excluded from this incentive program.

**Existing awards and proposals submitted prior to November 15, 2015, including non-competing continuation proposals, will follow the incentive plan outlined in Article VIII of the 2004-2009 collective negotiations agreement with UMDNJ; however faculty were given the choice to opt for the new extramural support incentive award from the 2013-2018 agreement between Rutgers and AAUP-BHSNJ for continuations of grants submitted prior to November 15, 2015. If applicable, please indicate the grant(s) submitted prior to November 15, 2015 for which you are seeking an extramural support incentive and note which incentive plan you previously selected.

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Faculty Member’s Signature Date Title

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Typed or Printed Name of Faculty Member Name of Department and School/Unit

PART B –TO BE COMPLETED BY THE GRANTS DEPARTMENT

SECTION I- TO BE COMPLETED BY THE GRANTS DEPARTMENT IN CASES WHERE THE FORMER EXTRAMURAL SUPPORT INCENTIVE PROGRAM APPLIES

If the faculty member has grants submitted prior to November 15, 2015, and has chosen to follow the former incentive program from the 2004-2009 collective negotiations agreement with UMDNJ, I certify that the above named faculty memberis both the principal author and principal investigator of the grant(s) listedin Part A which provide salary support for his/her own salary.

I certify that this faculty member is not required to support a percentage of his/her salary using outside grant funds as a condition of theiremployment.

The total amount of salary support the faculty memberreceived from this grant in FY2017is $______.

Amount of bonus to be awarded $ ______

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Signature of Authorized Representative of the Date

Grants Department

SECTION II- TO BE COMPLETED BY THE GRANTS DEPARTMENT IN CASES WHERE THE CURRENTEXTRAMURAL SUPPORT INCENTIVE PROGRAM APPLIES

I certify that the information provided in Part A is accurate and that the faculty member has grants submitted prior to June 30, 2017 and, if applicable, has opted for the incentive program outlined in the 2013-2018 agreement between Rutgers and AAUP-BHSNJ.

Faculty member’s totalFY2017 salary (academic base/faculty practice/patient services)is ______.

The total amount of salary support the faculty member received from extramural sponsored researchawards in FY2017was: $ ______.

List the amount of research incentive to be awarded is: $ ______(please include calculation for research incentive below or attach sheet).

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Signature of Authorized Representative of the Date

Grants Department

PART C – DEPARTMENT CHAIR/SUPERVISOR AUTHORIZATION

I certify that the information provided in Parts A and B is accurate.

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Signature of Department Chair/Supervisor Date

The Department Chair/Supervisor shall submit this form to the business manager of his/her school/unit for processing.

PART D - THEFOLLOWING SHOULD BE COMPLETED BY THE BUSINESS MANAGER

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Name of Bargaining-Unit Member Employee ID# Department/Unit

is entitled to an extramural support incentive bonus of $ ______

to be paid from Account # ______.

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Signature of Business Manager Date

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Printed Name of Business Manager

The Business Manager must submit the form to Payroll by Friday, September 1, 2017, to ensure payment no later than September 30th.

Please direct any questions about this program to Meredith Mullane, Executive Director of RBHS Faculty Affairs, at (973) 972-7037 or .

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