Division of Academic Affairs
Academic Resources and Planning
Administration Building, 3
rd
Floor
FACULTY REQUEST FOR ADDITIONAL COMPENSATION
This form authorizes additional compensation to be paid as indicated below.
______________________________________________________
I. Name ______________________________________ EMPL ID_____________
Appointee Type _______________ Contract Dates ___________ to _____________
II. Requesting Department ___________Dept. Charge Code _____________
Description
______________________________________________________________________________
______________________________________________________________________________
III. Additional Compensation Amount __________________
PLEASE ATTACH A FLAT RATE FORM.
V. Approvals (If the assignment is in a department other than the faculty member's primary
department, then all supervisors of both departments must sign).
By signing below I acknowledge that I agree to the Terms and Conditions.
__________________________________________ ___________________________________
Appointee/Date Chairperson/Date
__________________________________________________ __________________________________________
Dean/Date
Provost Budget Office Director/Date
__________________________________________________
Provost/Date
For Provost Budget Office Only:
1.
Assignments for Tenured, Tenure-Track, Clinical, and Visiting Faculty over $5,000 must go to the University Budget Office before
submission to the Payroll Office. Otherwise, submit this form directly to the Payroll Office for processing.
2.
Assignments for Lecturers and Adjunct Faculty over $5,000 must go to the University Budget Office before submission to Human
Resources. Otherwise, submit this form directly to Human Resources for processing.
IV.
On average the estimated hours per week over a 30 day period expected to be worked
on this project __________
(Only Lecturers and Adjunct Faculty complete sect IV.)
Please select an additional compensation category
(For Tenured, Tenure Track, Clinical, Visiting, Lecturers, and Adjunct Faculty)
University Budget Office/Date (for all payments > $5,000)
Office of University Research Services (if grant-funded)
If this assignment is funded by a
grant, please visit the
for additional required documents.
(select your primary role at Towson University)
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