Time and Effort Personnel Activity Certification

Captures employee certification of percentage of effort across federal awards on a semi-annual or after-the-fact basis. Used by grant accountants per 2 CFR 200.430 to support payroll charges.

Certification Period and Employee Information

• Employee Full Name
• Employee ID / HR System Number
  As assigned in your HR or payroll system.
• Department / Organizational Unit
• Position Title
• Reporting Basis
  Select whether this is a semi-annual or after-the-fact certification per 2 CFR 200.430(i).
• Certification Period Start Date
• Certification Period End Date
• Appointment Type

Effort Allocation by Award

• Effort Allocation by Funding Source
  Add one row per award or activity. Percentages must sum to 100%.
• Total Effort Percentage (must equal 100%)
  Sum of all rows above. Enter 100 to confirm allocations are complete.
• Does any award above include a cost-sharing or matching commitment?
• Cost-Sharing Detail
  Identify the award(s) and describe the cost-sharing commitment (e.g., 5% effort on Award #ABC-123 per approved budget).

Payroll Reconciliation Confirmation

• Are the effort percentages above consistent with actual payroll charges to each award?
• Describe Required Payroll Adjustment
  Identify the award(s), dollar amount(s), and reason for the cost transfer. Contact your grant accountant to initiate the correction.
• Was any portion of this period covered by paid leave (vacation, sick, FMLA)?
• Approximate Leave Dates
  Provide approximate dates. Leave charged to a federal award must comply with your organization's leave policy applied consistently.

Employee Certification and Signature

• I certify that the information provided is accurate and reflects actual effort devoted to each listed award and activity during the certification period.
• Employee Signature
  Draw or apply your electronic signature to certify this report.
• Date Signed by Employee
• Additional Comments (Optional)

Supervisor or PI Countersignature

• Is a supervisor or PI countersignature required for this certification?
• Supervisor / Principal Investigator Name
• Supervisor / PI Title
• The supervisor/PI confirms the effort allocations above reflect actual work performed to the best of their knowledge.
• Supervisor / PI Signature
• Date Signed by Supervisor / PI

Grant Accountant Use Only

• Review Status
• Cost Transfer / Journal Entry Reference Number
• Reviewer Notes
• Reviewed By (Grant Accountant Name)
• Date of Review
• Record Retention Confirmed (retain 3 years post-award closeout per 2 CFR 200.334)