Bvari boston va research Institute, Inc. 150 S. Huntington Avenue (151B) Boston, ma 02130 (617) 738-1313 (617) 738-8480 fax bonus/ Merit-Based Increase Request form

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Boston VA Research Institute, Inc.

150 S. Huntington Avenue (151B)

Boston, MA 02130

(617) 738-1313

(617) 738-8480 FAX

Bonus/ Merit-Based Increase Request form

Employee Name: _________________________________________________

Job Title: __________________________________________________

Department: __________________________________________________

Immediate Supervisor: __________________________________________________
BVARI’s standard Bonus/Merit Increase is up to 3%. If you are requesting a larger increase please include an updated CV, and in depth justification for the increase.

Ie: promotion, salary adjustment etc…

Performance based bonus

Current Salary:_______________

% of Bonus:_________________

Merit Based Increase

Requested Amount:____________ Effective Date:_______________


Based on the following reasons: _______________________________________________________________________




I have verified available funding in my grant and by signing acknowledge that such funding is available to cover this increase and/or bonus

Manager Print Name Signature Date

Principal Investigator Print Name Signature Date

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