Financial statement

This is a binding commitment to finance or partly finance a PhD fellowship at The Graduate School of Health, Aarhus University.

All expenses regarding the completion of the PhD degree programme; salary, including coverage of maternity/paternity leave, illness, study fee and other running costs in the enrolment period has to be covered by the place of employment.

Please indicate to which extend the PhD student has received funds from The Graduate School:

The PhD student has not received a fully financed PhD fellowship or a research training supplement for the department (550,000 DKK)

The PhD student has received a research training supplement for the department (550,000 DKK)

The PhD student has received a fully financed PhD fellowship from The Graduate School (skip the study fee section)

Has the project had a fellowship granted by the Faculty as part of a larger application for funds?
No: Yes: - please state the name of project owner and name of the project/area:

Basic information

PhD student:
PhD student’s email address:
Main supervisor:
Enrolment start date:
Enrolment end date:
Planned periods of leave? / No: Yes: Periods of leave
Place of employment*:
Full address:
Contact person(involved in accounting, to contact in regards to any transfer of fellowship):
Phone:
Email:

*Department, company, organisation or the like.

Sources of funds for the project (at the time of enrolment)
Please state from where the funds for the project have been obtained – if possible state the amount of the grant.

Grant awarded by / Amount (DKK)

Study fee


The study fee amounts to 180,000 DKK. No study fee will be charged if the PhD student has received a fully financed PhD fellowship or is enrolled as an Industrial PhD. The study fee will be charged in 3 rates (also for students enrolled part time or in case of leave etc.); the first rate in connection with enrolment and the following two the following years in the first quarter.

If the study fee is paid from an Aarhus University account, please fill out the Delregnskab, Sted, and Projekt in the box(es) on the last page and sign there.

Already billed study fee rates will not be reimbursed if the PhD student resigns from the PhD degree programme or for other reasons. Please fill out below box/boxes below:

Industrial PhD / Yes: - skip the remaining information regarding study fee
Name/company:
Billing address:
Contact person:
EAN no.: (if paid by a non-Aarhus University account)
Payment period and amount / DKK

Date:

______

Payer’s signature - CAPITAL LETTERS AND SIGNATURE

Name/company:
Billing address:
Contact person:
EAN no.: (if paid by a non-Aarhus University account)
Payment period and amount / DKK

Date:

______

Payer’s signature - CAPITAL LETTERS AND SIGNATURE

Employment

If employed as a PhD fellow at Aarhus University

Date:

______

Signature of the Head of Department at Aarhus University (“Institutleder”)

The Head of Department vouches for the financing of the entire PhD degree programme; including salary in accordance with collective and other agreements, coverage of maternity/paternity leave, illness and other running costs in the enrolment period.

During the enrolment period, the PhD student will only be expected to work on the PhD project and on tasks that are related to the project according to the PhD Plan.

Please fill in;

The form regarding employment as PhD fellow at Aarhus University: “Recommendation for employment as a PhD fellow…” and the “New employee information form” – both can be found here: http://phd.health.au.dk/application/employmentasaphdfellow/

Both have to be enclosed when handing in this financial statement.

If not employed by Aarhus University

Date: Date:

______

Signature of the Head of Department Place of employment (the financially
at Aarhus University (“Institutleder”) accountable – capital letters and signature)

The place of employment vouches for the financing of the employment of the PhD student for the entire PhD enrolment period; including salary in accordance with collective and other agreements, coverage of maternity/paternity leave, illness and other running costs.

During the enrolment period, the PhD student will only be expected to work on the PhD project and on tasks that are related to the project according to the PhD Plan.

The Head of Department guarantees that the full cost of the PhD project applied for (except the salary) is available at the Department.

Internal transfer of Study fee

If the study fee has to be paid by an Aarhus University account, please fill in the right hand side of the box/boxes below and sign.

Artskonto / 4520 / Artskonto / 4320
Moms / 10 / Moms / 10
Delregn. / 1 / Delregn.
Sted / 4026 / Sted
Projekt nr. / 12073 / Projekt nr.
Aktivitets nr. / 91102 / Aktivitets nr.
Beløb / -60.000,00 / Beløb
Dato / Ydelse modtaget / Dato / Ydelse modtaget
Dato / anvisning / AU ID / Dato / anvisning / AU ID
Artskonto / 4520 / Artskonto / 4320
Moms / 10 / Moms / 10
Delregn. / 1 / Delregn.
Sted / 4026 / Sted
Projekt nr. / 12073 / Projekt nr.
Aktivitets nr. / 91102 / Aktivitets nr.
Beløb / -60.000,00 / Beløb
Dato / Ydelse modtaget / Dato / Ydelse modtaget
Dato / anvisning / AU ID / Dato / anvisning / AU ID

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