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[]
[]
[]
[null,"Employee Name",null,null,null,null,"Employee ID ",null,"College / Department "]
[]
[null,"Job Title",null,null,null,null,"Position #",null,"GEMS DeptID"]
[]
[null,"Proposed Effective Date:",null,null,null,null,null,null,"Bargaining Unit:"]
[]
[null,"Please indicate the reason for the proposed increase and provide documentation as an attachment."]
[]
[null,"REASON FOR REQUESTED SALARY ADJUSTMENT (select from Drop Down Menu Below)"]
[null,"(REQUIRED FIELD)"]
[]
[]
[null,null,"Current Salary / Stipend",null,"Current Stipend End Date",null,"Amount of Proposed Increase",null,"New Total Salary",null,"New Stipend End Date",null,"Increase Percent"]
[null,"Base",null,null,null,null,null,null,{"$f":"C17+G17","v":0},null,null,null,{"$f":"IFERROR(G17/C17,\"\")","v":""}]
[null,"Stipend 1",null,null,null,null,null,null,{"$f":"C18+G18","v":0},null,null,null,{"$f":"IFERROR(G18/C23,\"\")","v":""}]
[null,"Stipend 2",null,null,null,null,null,null,{"$f":"C19+G19","v":0},null,null,null,{"$f":"IFERROR(G19/C23,\"\")","v":""}]
[null,"Stipend 3",null,null,null,null,null,null,{"$f":"C20+G20","v":0},null,null,null,{"$f":"IFERROR(G20/C23,\"\")","v":""}]
[null,"Stipend 4",null,null,null,null,null,null,{"$f":"C21+G21","v":0},null,null,null,{"$f":"IFERROR(G21/C23,\"\")","v":""}]
[]
[null,"TOTALS:",{"$f":"SUM(C17:C21)","v":0},null,null,null,{"$f":"SUM(G17:G21)","v":0},null,{"$f":"SUM(I17:I21)","v":0},null,null,null,{"$f":"IFERROR(G23/C23,\"\")","v":""}]
[]
[null,"Funding available from Department / College?",null,null,null,null,"Select one"]
[null,null,null,null,"Source of Available Funding: (Check all that apply)"]
[]
[]
[null,null,"Chartfield(s):",null,null,null,null,"Combo Code(s):",null,null,null,"Percent Assigned"]
[]
[]
[]
[]
[]
[null,null,null,null,null,null,"OR"]
[null,"If One Time Bonus:  "]
[null,"Amount of One Time Bonus",null,null,"Chartfield ",null,null,null,null,null,"Combo Code"]
[]
[]
[]
[]
[null,"Preparer",null,null,null,null,"Signature",null,null,null,null,null,"Date"]
[]
[null,"Chair / Director",null,null,null,null,"Signature",null,null,null,null,null,"Date"]
[]
[null,"Dean or Designee",null,null,null,null,"Signature of Approval",null,null,null,null,null,"Date"]
[]
[null,"Charles J. Lockwood, MD, MHCM",null,null,null,null,null,null,null,null,null,null,"Date"]
[null,"Sr. V.P. USFH, Dean MCOM"]
[]
[null,"***Attach Explanation for change and additional information as necessary. ***"]
[]
[]
[]
[null,"Must Select an Option"]
[null,"Base-Market Equity (Market Equity)"]
[null,"Base-Sustained Superior Performance (Merit/Discretion)"]
[null,"Base - Promotion (Outside the Standard APT Process)"]
[null,"Base-Other"]
[null,"SPI-Counter Offer (Counter Offer)"]
[null,"Stip/SPI-Addl High Duties – Perm (Administrative Duties)"]
[null,"Stip/SPI-Temp Higher Duties (Temporary Stipend)"]
[null,"(RSS) Research Salary Support"]
[null,"(ECSS) Educational/Contract Salary Support"]

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["Faculty Salary Adjustment Form: Types of Increases"]
[]
["Included in Discretionary Cap"]
["·         Base-Market Equity (Market Equity)"]
["o   An increase to the base salary to address an internal or external inequity in salary."]
["·         Base-Other (Other)"]
["o   An increase to the base salary for reasons that don’t fit any other reason.  Typically, used when renegotiating salary such as when extending a Visiting appointment with a salary increase or a Chair reappointment."]
["·         Base-Sustained Superior Performance (Merit/Discretion)"]
["o   An increase to the base salary for significant superior performance such as outcomes and/or goal accomplishments which have a long-term, cumulative impact or consistently superior performance over a number of years.  "]
["o   May be used for retention of an individual who has made significant accomplishments at USF."]
["o   Base increase as part of a college/department career progression program, such as the career path programs in CUTR and FMHI."]
["o   Not part of a bargained salary adjustment."]
["·         SPI-Counter Offer (Counter Offer)"]
["o   An increase to the base salary in response to a verified job offer from another institution."]
[]
["Not Included in Discretionary Cap"]
["·         Stip/SPI-Addl High Duties – Perm (Administrative Duties)"]
["o   An increase to the base salary in recognition of newly-assigned administrative or other duties that are expected to be long-term.  For example, when first assigned responsibilities as a Chair or additional administrative duties on a grant."]
["·         Stip/SPI-Temp Higher Duties (Temporary Stipend)"]
["o   A pay additive that is limited in duration in recognition of newly-assigned administrative or other duties."]
["·         (RSS) Research Support Salary (Temporary Stipend)"]
["o   Portion of a Clinician's salary that is provided based on merit and is considered annually at the beginning of each contract period."]
["·         (ECSS) Education/Contract Support Salary - (Temporary Stipend)"]
["o   Portion of a Clinician's salary that is provided based on educational merit or extramural contract funds and is considered annually at the beginning of each Fiscal year."]

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