<p> University of Massachusetts Dartmouth Approval Form - Additional Compensation (Stipends) for Temporary Duties Professional Employees Engaged in Non-Instructional Activities</p><p>Name of Employee Department </p><p>Dates services to be performed: From To </p><p>Total Amount Requested $ Bi-weekly Amount $ OR Hourly Rate $ Amount Allocated Through June 30th $ $ Amount Allocated From July 1st To End Date $ Total $ Amount Allocated $ HR Acct Code Proj/Grant No: How did you arrive at this amount?</p><p>Detailed Description of Work to be Performed:</p><p>Is this work outside of the scope of current responsibilities substantial increase of current duties If outside the scope, please give a detailed explanation of why you have made this determination.</p><p>Does this work fall within the scope of another employye’s current responsibilities? Yes No If yes, what is the reason they are not being performed by that employee?</p><p>If a substantial increase, please give a detailed explanation of what measures were used to make this determination.</p><p>Work that is a substantial increase must be done outside of normal work hours. Who will monitor this?</p><p>What is the impact on the University if these services are not performed?</p><p>Other Additional Compensation: Do you anticipate other additional compensation for this employee from any other sources? Effective Date End Date Bi-weekly Amount Total Amount</p><p>Supervisor</p><p>Funding Department (if Different from Supervisor)</p><p>Dean/Director/Department Head Director HR</p><p>Vice Chancellor:</p><p>Fiscal Payroll</p>