SUBMIT – F&A Waiver

F&A Waiver

"*" indicates required fields

Submitter Name*

Submitter Email*

PI Name*

Funding Proposal or Award ID # (if applicable)*

Department/Unit Name*

Cost Center*

Sponsor Name*

Does the Sponsor/Solicitation have a published F&A/indirect cost rate?*

Yes

Published F&A/indirect cost rate (%)*

Please upload documentation to verify Sponsor's rate*

Max. file size: 100 MB.

If the Sponsor has no published rate, UVA's standard rates will apply unless waiver is approved.*

Acknowledged

Default F&A Rate Type*

Requested Waiver*

Reduced F&A Rate

Full F&A Waiver

Reduced F&A Rate (%)*

**It is the expectation that some or all of the costs pertaining to the waiver be borne by the PI’s home department/unit. These funds will be recovered by the SOM from the Department/Unit's non-sponsored account. ***

Acknowledged

What amount of the waived F&A/indirect costs will be covered by the department/unit's non-sponsored funding source?*

Worktag(s) for department/unit's portion of costs*

Budget Summary with Full/Published F&A Rate (Please Complete)

Salary/Fringe*

OTPS*

F&A Base (MTDC or TDC)*

F&A at Full/Published Rate*

Total Budget*

Budget Summary with Reduced F&A Rate (Please Complete)

Salary/Fringe*

OTPS*

F&A Base (MTDC or TDC)*

F&A at Reduced Rate*

Total Budget*

Hidden

On Grounds Research

Hidden

Off Grounds Research

Hidden

On Grounds OSA

Hidden

Off Grounds OSA

Hidden

Clinical Trials

Amount of F&A Covered by Department

Amount of F&A Covered by Sponsor

Amount of F&A Waived by SOM

Justification for Request - Include: 1) The scientific merits of the program; 2) Role of the program within the overall mission of the School of Medicine and the University; 3) Availability of funding*

Other Uploads (please include a detailed budget)

Drop files here or

Max. file size: 100 MB.

PI and Chair Approvals*

Drop files here or

Max. file size: 100 MB.

Fillable ResearchUVA/Huron Approvals Document