University Of Massachusetts Dartmouth

University of Massachusetts Dartmouth

Approval Form - Additional Compensation (Stipends) for Temporary Duties

Professional Employees Engaged in Non-Instructional Activities

Name of Employee / Department
Dates services to be performed: From / To
Total Amount Requested $ / Bi-weekly Amount $ / OR Hourly Rate $
Amount Allocated Through June 30th / $
$ Amount Allocated From July 1st To End Date / $
Total $ Amount Allocated / $ / HR Acct Code
Proj/Grant No:
How did you arrive at this amount?
Detailed Description of Work to be Performed:
Is this work outside of the scope of current responsibilities substantial increase of current duties
If outside the scope, please give a detailed explanation of why you have made this determination.
Does this work fall within the scope of another employye’s current responsibilities? Yes No
If yes, what is the reason they are not being performed by that employee?
If a substantial increase, please give a detailed explanation of what measures were used to make this determination.
Work that is a substantial increase must be done outside of normal work hours. Who will monitor this?
What is the impact on the University if these services are not performed?
Other Additional Compensation: Do you anticipate other additional compensation for this employee from any other sources?
Effective Date / End Date / Bi-weekly Amount / Total Amount
Supervisor
Funding Department (if Different from Supervisor)
Dean/Director/Department Head / Director HR
Vice Chancellor:
Fiscal / Payroll