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

BVARI Boston VA Research Institute, Inc. 150 S. Huntington Avenue (151B) Boston, MA 02130 [phone] [phone] 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:_______________

Job#:_______________________

Based on the following reasons: _______________________________________________________________________

________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________

Certification

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