Download:
pdf |
pdfOMB Approval No.:4040-0001
Expiration Date: mm/dd/yyyy
RESEARCH & RELATED BUDGET- Budget Period 1
• ORGANIZATIONAL DUNS:
• Budget Type:
Enter name of Organization:
!D Project D Subaward/Consortiurn
Budget Period: 1
A. Senior/Key Person
Prefix
• First
Mlddlo
• Last
Suffix
Additional Senior Key Persons: L---------------'
Base Salary($)
Add Attachment
11
• Project Role
Post Doctoral Associates
Graduate Students
Und ergraduate Students
Secretarial/Clerical
Total Number Other Personnel
L!
___......J
Months
Acad. Sum.
Oale:e Attachment
View Alracn'!leot
11
I
B. Other Personnel
• Number of
Personnel
Cal.
• Start Date:
Cal.
Months
Acad.
Sum.
• End Date:
• Requested
Salary($)
._I _____.
• Fringe
Be neflts ($)
Total Funds requested for all Senior
Key Persons In the attached file
• Requested
Salary($)
• Funds
Requested($)
c___________,
Total Senior/Koy Person
• Fringe
Benoflts($)
• Funds
Requested($)
c=JCJI I
I ===�I !:=====
CJ CJ c=J ::=
I
=======!
c=JCJc=J
CJ CJc=J !=I===�I !=====!
I
:=======!
c=JCJc=J
Total Other Personnel
Total Salary, Wages and Fringe Benefits (A+B)
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid
OMB control number for this information collection is 4040-0001. The time required to complete this information collection is estimated to average 1 hour per response,
including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments
concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200
Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer
File Type | application/pdf |
File Modified | 2016-08-16 |
File Created | 2016-08-16 |