Internal Clearance Form Cost-Sharing Addendum


Indicate the faculty/staff salary and fringe benefits committed as match to this project or research: (excludes salary/fringes charged directly to grant or contract)  (fringe benefits will be paid by University centrally)

Name:
Employee ID#
Dept. ID#
WTU or % of full position Total Project
Salary:
Fringe:
Period of Commitment:
(mm/dd/yy)
Position Pool ID#:


, or
$
$



, or
$
$



, or
$
$



, or
$
$



, or
$
$

Transfer total to line 9.f. of Internal Clearance Form