IK-4 03/09/18
Internal In-Kind Salary Match Summary Form
Project Name: ____________________________________________________________________________
Index No.: ____________ Principal Investigator: ______________________________________________
Project Period: __________________ Department:______________________________________________
Funding Agency: __________________________________________________________________________
Report Period for Matching Cost Items Noted Below: _____________________________________________
Reminder: Proper documentation must be maintained for all items noted as "in-kind match as they are subject to federal
audit. The dollar value of these non-cash donations should be calculated at their verifiable fair-market value.
Names of Individuals Working on This Project for
Which You Have Obtained Timesheets
Departmental Account
of Faculty/Staff
Providing Cost Share
# Hours
Reported
Cost Sharing Total
for This Period
TOTAL COST SHARING
I hereby certify as the Principal Investigator for this project that those individuals named above worked on this project.
Signature:______________________________________
Date:___________________________________________
*The Principal Investigator must send a copy of this form to the project bookkeeper and Grant
Accounting on a monthly basis. Copies of timesheets must accompany this form.
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