UW Research
Forms and Templates

Initial Application for Reduced Responsibility Status

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FORM INSTRUCTIONS

Use this form when a faculty member is participating in RR Status.

  1. Enter the date that the form is filled out.
  2. Designate the reporting period.
  • Initial Application – the faculty member is not currently on RR Status but anticipates starting.
  • Year 2 and Year 3 – faculty members on RR status must document their RR Status once per year.
  • Mid-cycle Change – the faculty member’s salary distribution changes mid-year.
  • End RR Status – the faculty member is returning to full appointment status.
  1. Enter the effective date (i.e., the date that salary distributions will change)

Faculty Information

  1. Enter identifying information about the faculty member.
  2. Enter the faculty member’s current faculty appointment.
  3. Enter the faculty member’s monthly institutional base salary
  4. Enter the correct service period for the faculty appointment

Part A:  Distribution of Responsibilities at Appointment Level PRIOR to RR Status

If there are more than two sources of external funding impacted by the change use Form B: Modification to Reduced Responsibility Status to document all sources impacted. Enter the total on Form B in the total line on Form A: Initial Application.  Staple the forms together.

  1. Enter the short titles of each external source of funding impacted (e.g., Grant/Gift A).
  2. Enter the corresponding % effort this faculty member is being paid from each source listed. If part of the effort for a sponsored project is being contributed as cost-sharing, that %FTE should be included as part of the Institutional Scholarly Activities, and a footnote added to indicate the % FTE that is cost shared for each sponsored project where cost sharing is provided.
  3. Enter the corresponding monthly salary amount this faculty member is being paid for this work.
  4. Enter the corresponding budget number for each funding source impacted by this change.
  5. Enter the amount of effort (%) and paid time (salary) for any scholarly activities – grant writing, teaching and mentoring, clinical service, cost-sharing related to sponsored projects, etc. Include in this entry in the amount of effort (%) and paid time (salary) for any supplemental pay the faculty member receives. Note, ADS and ENS are listed in HEPPS.
  6. Calculate the totals. The “Total Paid Monthly IBS” should be the same number as the “Monthly Institutional Base Salary” listed in the top portion of this form. The “Effort (%)” should be the same as the “Appointment FTE” listed in the top portion of this form.

Part B:  Distribution of Responsibilities DURING RR Status

If there are more than two sources of external funding impacted by the change use Form B to document all sources impacted.  Enter the total on Form B in the total line on Form A. Staple the forms together.

  1. Enter the short titles of each external source of funding (i.e., Grant/Gift A).
  2. Enter the corresponding % effort this faculty member will be paid (grant funding and cost share funding).
  3. Enter the corresponding salary amount this faculty member will be paid for this work.
  4. Enter the corresponding budget number for each external funding source.
  5. Enter the amount of effort (%) and paid time (salary) for any scholarly activities – grant writing, teaching, clinical service, cost sharing for sponsored projects, etc.. Include the amount of effort (%) and paid time (salary) for any supplemental pay the faculty member will receive. ADS and ENS is listed in HEPPS – where?
  6. Enter the percentage of time in RR Status. This will be entered as RRD (reduced responsibility distribution) in HEPPS.
  7. Calculate the totals.
  8. Enter the difference in %FTE that represents the change in FTE and salary due to RR from the original amount prior to RR Status.

Authorization

  1. Each RR Status form must be signed by the faculty member, chair or director and the dean or chancellor.

Submitting this form:

  1. Print Form A as well as Form B is used.
  2. Gather the required signatures at the bottom of Form A.
  3. Send the original to the Department Chair or Program Director.
  4. Send copies to any Joint Appointment Departments.
  5. Provide a copy to the faculty member.

Review GIM 38 – Faculty Reduced Responsibility Status Involving External Funding.