UW Research
Forms and Templates

Modification to Reduced Responsibility Status



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 t

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