Actual Wage Explanation - Internal

[*This form does not apply to Medical Residents & Fellows, and employees within a bargaining unit, i.e. AAUP or CWA.]

List employees in the department with the same job classification. When there are no other people in the department with the same job classification, use others with the same job classification in other departments. Use additional paper if needed. If another employee has a higher wage than the H-1B employee, please list the reasons for this difference. Legitimate reasons include more years of experience, supervision of other employees, or a sub-specialty required for the position. Non-legitimate factors include H-1B employee’s willingness to work for less money, lowest negotiated salary, abilities or qualifications irrelevant to the position, market conditions, or lack of internal or external funding to pay the salary or wage.

*EXPLAINING WHY A FELLOW EMPLOYEE WITH SIMILAR JOB DUTIES MAKES A HIGHER SALARY OR WAGE THAN THE H-1B EMPLOYEE IS REQUIRED. IT DOES NOT MATTER IF THE FELLOW EMPLOYEE IS A U.S. CITIZEN OR OTHERWISE.

Employee Name Job Title Degree Required Department pay Full-time or part- Annual salary or (alphabetical for position range time (if part- hourly wage order) (minimum) time, # of hours expected per week)

Dr. John Doe

Reasons why Dr. Doe makes higher salary than Dr. [H-1B employee]:  [more years of experience?]  [supervises other employees?]  [specializes in more complicated area than Dr. [H-1B employee]?]

Dr. H-1B Employee

Dr. Jane Doe

I certify the salaries listed above reflect the wage rate paid to all employees with the same job classification in this department. I am able to give reasons acceptable to DOL for significant differences in the wage rate and can provide documentation to support this.

Departmental Authorized Signature ______

Print Name ______Title ______

Date ______

Snyder Memorial 1020 – 2801 W. Bancroft St., MS 120, Toledo OH 43606 Phone: 419.530.4229 – Fax: 419.530.4244 – utoledo.edu/cisp/international