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RESEARCH TIME, EFFORT, AND COMPENSATION OVERLOAD AUTHORIZATION (Louisiana Tech University)

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RESEARCH TIME, EFFORT, AND COMPENSATION
OVERLOAD AUTHORIZATION
As possible, this form is to be initiated before overload employment is undertaken.
Use “comment” section to justify exceptions to time requirement.
IDENTIFICATION OF INDIVIDUAL TO RECEIVE OVERLOAD
Name:____________________________________________________________SSN:_________________________________
Title:___________________________________Department/Unit:_________________________________________________
Employment Basis: ______ 9 mo. ______ 10 mo. ______ 12 mo. ______ Part-time _____Other (Specify__________________)
Overload compensation (teaching and research) per fiscal year (July 1 - June 30) is limited to 20% of an employee’s annualized
salary, excluding displacement.
.
Project Title:____________________________________________________________________________________________
Project P.I.:__________________________________________ Project Account No.:______________________________
TIME
What percentage of time will Individual devote to project?______% per week, or ______% per month, or ______% per quarter
Comments:______________________________________________________________________________________________
_____________________________________________________________________________________________________
EFFORT
Describe the activities the Individual will contribute to the Project:_________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Will these activities interfere with the Individual’s regular workload: ______No ______ Yes. Explain___________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
COMPENSATION
Will the Individual receive release time? ______ No ______Yes. If yes, explain how Department/Unit will fulfill Individual’s
regular workload obligations:_______________________________________________________________________________
______________________________________________________________________________________________________
Will this compensation be paid as summer salary? ______No ______Yes.
PAYMENT
Effective Date(s):_________________________________________________
Amount monthly ________ Amount one-time payment_________Date 1
st
payment__________ Date last payment
____________
Total Overload Compensation ______________________
Total Revised Annual Compensation* (to be completed by Personnel):______________________________________
*add overload compensation to regular salary (excluding displacement)
Requested by: __________________________________________ _______________________________________________
Principal Investigator Date University Research Date
___________________________________________ _______________________________________________
Department/Unit Head Date Dean, Grad School & Univ Res. Date
___________________________________________ _______________________________________________
Dean of the College Date Vice President Date
_______________________________________________
President Date
Personnel Office: Date Received: ___________________________ Signature:_______________________________________
Overload 6/01
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RESEARCH TIME, EFFORT, AND COMPENSATION OVERLOAD AUTHORIZATION (Louisiana Tech University)

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Completed 23 July 2020

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