Effort Certification Form

April 10, 2010 | By forms examples | Reply More

An effort certification form is necessary to document the fairness, consistency and timeliness of sponsored funds. The form acts as evidence that can be used to confirm the effort made on projects that are sponsored externally. The form must be filed in correctly and accurately. Below is a sample effort certification form.

Sample Effort Certification Form

Sponsored Program Funds

Effort Report for _________________________ Contract Year __________________

Department _____________________________

Fund No Fund Description Effort

__________________ _____________________________ ___________

__________________ _____________________________ ___________

__________________ _____________________________ ___________

__________________ _____________________________ ___________

__________________ _____________________________ ___________

Current Distribution of Effort

Staff Year __________________

Activity Effort to Date Percentage Distribution

__________________ _________________ ___________________

__________________ _________________ ___________________

__________________ _________________ ___________________

__________________ _________________ ___________________

__________________ _________________ ___________________

Total________________

Source of Pay ____________________

Total Effort ______________________

Cost shared effort for ______________

Total sponsored effort ______________________

Total non-sponsored effort __________________

Comments by preparer

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Preparer _____________________ Sign __________________________

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