4040-0001 R&R Federal/Non-Federal Budget (up to 5 years)

OMB Number: 4040-0001
Expiration Date: 06/30/2011

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION A, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
Project

* Budget Type:

Subaward/Consortium

Enter name of Organization:
* Start Date:

* End Date:

* Budget Period:

1

A. Senior/Key Person
1. Prefix

* First Name

Middle Name

* Last Name

Suffix

* Project Role
PD/PI
Base Salary ($)

2. Prefix

Cal.
Months

Acad.
Months

Sum.
Months

* Req. Salary ($)

* First Name

* Fringe Ben. ($)

Middle Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

3. Prefix

Cal.
Months

Acad.
Months

Sum.
Months

* Req. Salary ($)

* First Name

* Fringe Ben. ($)

Middle Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

4. Prefix

Cal.
Months

Acad.
Months

Sum.
Months

* Req. Salary ($)

* First Name

* Fringe Ben. ($)

Middle Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

Cal.
Months

Acad.
Months

Sum.
Months

* Req. Salary ($)

RESEARCH & RELATED Budget {A} (Total Fed + Non-Fed)

* Fringe Ben. ($)

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Federal ($)

* Non- Federal ($)

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION A, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
* Budget Type:

Project

Subaward/Consortium

Enter name of Organization:
* Start Date:

Budget Period

* End Date:

1

A. Senior/Key Person (continued)
5. Prefix

* First Name

Middle Name

* Last Name

Suffix

* Project Role

Base Salary ($)

6. Prefix

Cal.
Months

Acad.
Months

Sum.
Months * Req. Salary ($)

* First Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Fringe Ben. ($)

Middle Name

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

7. Prefix

Cal.
Months

Acad.
Months

Sum.
Months * Req. Salary ($)

* First Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Fringe Ben. ($)

Middle Name

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

8. Prefix

Cal.
Months

Acad.
Months

Sum.
Months * Req. Salary ($)

* First Name

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Fringe Ben. ($)

Middle Name

* Federal ($)

* Last Name

* Non- Federal ($)

Suffix

* Project Role

Base Salary ($)

Cal.
Months

Acad.
Months

Sum.
Months * Req. Salary ($)

* Fringe Ben. ($)

* Total (Sal & FB)
(Fed + Non-Fed)($)

* Federal ($)

9. Total Funds requested for all Senior Key Persons in the attached file
Total Senior/Key Person
* Additional Senior Key Persons:
RESEARCH & RELATED Budget {A} (Total Fed + Non-Fed)

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* Non- Federal ($)

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION B, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
Project

* Budget Type:

Subaward/Consortium

Enter name of Organization:
* Start Date:

* End Date:

Budget Period

1

B. Other Personnel
* Number of
Personnel * Project Role

Cal.
Months

Acad.
Sum.
Months Months

* Req. Salary ($)

* Fringe Ben. ($)

Post Doctoral Associates
Graduate Students
Undergraduate Students
Secretarial/Clerical

Total Number Other Personnel

Total Other Personnel
Total Salary, Wages and Fringe Benefits (A + B)

RESEARCH & RELATED Budget {B} (Total Fed + Non-Fed)

* Total (Sal & FB)
(Fed + Non-Fed) ($)

* Federal ($)

* Non- Federal ($)

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION C, D, & E, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
* Budget Type:

Project

Subaward/Consortium

Enter name of Organization:
* Start Date:

* End Date:

Budget Period

1

C. Equipment Description
List items and dollar amount for each item exceeding $5,000
* Federal ($)

* Equipment item

* Non-Federal ($)

* Total (Fed +
Non-Fed) ($)

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11. Total funds requested for all equipment listed in the attached file
Total Equipment
* Additional Equipment:

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D. Travel
1.

Domestic Travel Costs ( Incl. Canada, Mexico and U.S. Possessions)

2.

Foreign Travel Costs

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* Federal ($)

* Non-Federal ($)

* Federal ($)

* Non-Federal ($)

* Total (Fed +
Non-Fed) ($)

Total Travel Costs
E. Participant/Trainee Support Costs
1.

Tuition/Fees/Health Insurance

2.

Stipends

3.

Travel

4.
5.

Subsistence
Other

Number of Participants/Trainees

Total Participant/Trainee Support Costs

RESEARCH & RELATED Budget {C-E} (Total Fed + Non-Fed)

* Total (Fed +
Non-Fed) ($)

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION F-G, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
Project

* Budget Type:

Subaward/Consortium

Enter name of Organization:
* Start Date:

* End Date:

Budget Period

1

F. Other Direct Costs
* Federal ($)

* Non-Federal ($)

* Total (Fed + Non-Fed) ($)

* Federal ($)

* Non-Federal ($)

* Total (Fed + Non-Fed) ($)

1. Materials and Supplies
2. Publication Costs
3. Consultant Services
4. ADP/Computer Services
5. Subawards/Consortium/Contractual Costs
6. Equipment or Facility Rental/User Fees
7. Alterations and Renovations
8.

9.

10.

Total Other Direct Costs

G. Direct Costs
Total Direct Costs (A thru F)

RESEARCH & RELATED Budget {F-K} (Total Fed + Non-Fed)

RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - SECTION H-K, BUDGET PERIOD 1
* ORGANIZATIONAL DUNS:
* Budget Type:

Project

Subaward/Consortium

Enter name of Organization:
* Start Date:

* End Date:

Budget Period

1

H. Indirect Costs
* Indirect Cost Type

Indirect Cost
Rate (%)

Indirect Cost
Base ($)

* Federal ($)

* Non-Federal ($)

* Total (Fed + Non-Fed) ($)

1.

2.

3.

4.

Total Indirect Costs

Cognizant Agency

(Agency Name, POC Name, and Phone Number)

I. Total Direct and Indirect Costs

* Federal ($)

* Non-Federal ($)

* Total (Fed + Non-Fed) ($)

Total Direct and Indirect Costs (G + H)

J. Fee

K. * Budget Justification

RESEARCH & RELATED Budget {C-E} (Total Fed + Non-Fed)

Federal ($)

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RESEARCH & RELATED BUDGET (TOTAL FED + NON-FED) - Cumulative Budget
Total Federal ($)
Section A, Senior/Key Person
Section B, Other Personnel
Total Number Other Personnel
Total Salary, Wages and Fringe Benefits (A + B)
Section C, Equipment
Section D, Travel
1. Domestic
2. Foreign
Section E, Participant/Trainee Support Costs
1. Tuition/Fees/Health Insurance
2. Stipends
3. Travel
4. Subsistence
5. Other
6. Number of Participants/Trainees
Section F, Other Direct Costs
1. Materials and Supplies
2. Publication Costs
3. Consultant Services
4. ADP/Computer Services
5. Subawards/Consortium/Contractual Costs
6. Equipment or Facility Rental/User Fees
7. Alterations and Renovations
8. Other 1
9. Other 2
10. Other 3
Section G, Direct Costs (A thru F)
Section H, Indirect Costs
Section I, Total Direct and Indirect Costs (G + H)
Section J, Fee

RESEARCH & RELATED Budget (Total Fed + Non-Fed)

Total Non-Federal ($)

Totals ($)