University at Albany
Release Time Appointment Request
SUNY Employee Name:
Dollar amount to be reimbursed:
SUNY IFR Account Number:
RF Project-Task-Award:
Release Time Period:
(Cannot exceed project dates):
Contact Name/Number:
Department:
Comments/Justification: (required for any submission 90 days after the start date of the release time
period or to make a change to a previous appointment):
CERTIFICATIONS AND REPRESENTATIONS:
The employee noted above is being released from their SUNY obligation to perform work on a sponsored
project for the amount and period specified above. This assignment is consistent with sponsored
programs terms and conditions and with Research Foundation Policies.
SUNY Employee
Date
Principal Investigator
Date
Dean/Director/Chair
Date
Sponsored Programs Administration / Management Services Center 216
The University at Albany / 1400 Washington Avenue / Albany, New York 12222
Telephone (518) 442-3196 / Fax (518) 442-5208 / www.albany.edu/ams
9/10/15