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Fields
Submitter Information
Date/Time
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Month
Jan
Feb
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May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
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Year
2019
2020
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2029
Re-Org Completed By Lee?
Re-Org Completed
Requestor Affiliation
*
Department
OGC
Name
*
First Name
*
Last Name
*
Email
*
Phone
*
Org Reference Information
Principal Investigator Name
*
First Name
*
Last Name
*
Project/Program Number
*
ex: 25AXXXX
Speedtype
*
ex: 630XXXXX
Current ORG
*
ex: XXXXX
Current Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
New ORG
*
ex: XXXXX
New Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
Reason for Org Change Request
*
PI has moved
New Org was created
Incorrect Org requested on Routing
Incorrect Org used at Speedtype setup
Reason for Org Change Request
Additional explanation if needed
2nd PI/Project/Speedtype Change Needed?
Yes
2nd Org Reference Information
Principal Investigator Name
*
First Name
*
Last Name
*
Project Number
*
ex: 25AXXXX
Speedtype
*
ex: 630XXXXX
Contract/Sponsor Payment Type
*
Fixed Rate (FR)
Cost-Reimbursable, OGC Invoiced (CR)
Installment-Based (IB)
Letter of Credit (LC)
Current ORG
*
ex: XXXXX
Current Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
New ORG
*
ex: XXXXX
New Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
Reason for Org Change Request
*
PI has moved
New Org was created
Incorrect Org requested on Routing
Incorrect Org used at Speedtype setup
Reason for Org Change Request
Additional explanation if needed
3rd PI/Project/Speedtype Change Needed?
Yes
3rd Org Reference Information
Principal Investigator Name
*
First Name
*
Last Name
*
Project Number
*
ex: 25AXXXX
Speedtype
*
ex: 630XXXXX
Contract/Sponsor Payment Type
*
Fixed Rate (FR)
Cost-Reimbursable, OGC Invoiced (CR)
Installment-Based (IB)
Letter of Credit (LC)
Current ORG
*
ex: XXXXX
Current Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
New ORG
*
ex: XXXXX
New Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
Reason for Org Change Request
*
PI has moved
New Org was created
Incorrect Org requested on Routing
Incorrect Org used at Speedtype setup
Reason for Org Change Request
Additional explanation if needed
4th PI/Project/Speedtype Change Needed?
Yes
4th Org Reference Information
Principal Investigator Name
*
First Name
*
Last Name
*
Project Number
*
ex: 25AXXXX
Speedtype
*
ex: 630XXXXX
Contract/Sponsor Payment Type
*
Fixed Rate (FR)
Cost-Reimbursable, OGC Invoiced (CR)
Installment-Based (IB)
Letter of Credit (LC)
Current ORG
*
ex: XXXXX
Current Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
New ORG
*
ex: XXXXX
New Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
Reason for Org Change Request
*
PI has moved
New Org was created
Incorrect Org requested on Routing
Incorrect Org used at Speedtype setup
Reason for Org Change Request
Additional explanation if needed
5th PI/Project/Speedtype Change Needed?
Yes
5th Org Reference Information
Principal Investigator Name
*
First Name
*
Last Name
*
Project Number
*
ex: 25AXXXX
Speedtype
*
ex: 630XXXXX
Contract/Sponsor Payment Type
*
Fixed Rate (FR)
Cost-Reimbursable, OGC Invoiced (CR)
Installment-Based (IB)
Letter of Credit (LC)
Current ORG
*
ex: XXXXX
Current Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
New ORG
*
ex: XXXXX
New Org Description
*
ex: SOM-MED Sponsrd Pgms/Gft
Reason for Org Change Request
*
PI has moved
New Org was created
Incorrect Org requested on Routing
Incorrect Org used at Speedtype setup
Reason for Org Change Request
Additional explanation if needed
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