+----------------------+---------------+--------+---+---+-----------+
| #  CCR               |               |        |   |   |           |
|  ROUTE SLIP for T42  |               |        |   |   |           |
| Actions Revised 9/08 |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
|                      |               | ## D   | # |   | ##        |
|                      |               | ATE IN | # |   |  INITIALS |
|                      |               |        |   |   |           |
|                      |               |        | D |   |           |
|                      |               |        | A |   |           |
|                      |               |        | T |   |           |
|                      |               |        | E |   |           |
|                      |               |        |   |   |           |
|                      |               |        | O |   |           |
|                      |               |        | U |   |           |
|                      |               |        | T |   |           |
+----------------------+---------------+--------+---+---+-----------+
| ## AO Review         |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| ## Team Leader       |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| ## ARC Man           |               |        |   |   |           |
| ager (if applicable) |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| **Deputy Director,   |               |        |   |   |           |
| CCR (if              |               |        |   |   |           |
| applicable)**        |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| **CCR ARC (if        |               |        |   |   |           |
| applicable)**        |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| **Forward Package to |               |        |   |   |           |
| HR Specialist (name, |               |        |   |   |           |
| building, room):**   |               |        |   |   |           |
|                      |               |        |   |   |           |
| **     **            |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| **Employee Name:**   |               |        |   | * |           |
| [     ]{.underline}  |               |        |   | * |           |
|                      |               |        |   | F |           |
| **                   |               |        |   | T |           |
| Lab/Branch/Office:** |               |        |   | E |           |
| [     ]{.underline}  |               |        |   | : |           |
|                      |               |        |   | * |           |
| **Requested          |               |        |   | * |           |
| Effective Date:**    |               |        |   |   |           |
| [     ]{.underline}  |               |        |   | A |           |
|                      |               |        |   | l |           |
|                      |               |        |   | l |           |
|                      |               |        |   | o |           |
|                      |               |        |   | c |           |
|                      |               |        |   | a |           |
|                      |               |        |   | t |           |
|                      |               |        |   | e |           |
|                      |               |        |   | d |           |
|                      |               |        |   | F |           |
|                      |               |        |   | T |           |
|                      |               |        |   | E |           |
|                      |               |        |   |   |           |
|                      |               |        |   | L |           |
|                      |               |        |   | o |           |
|                      |               |        |   | a |           |
|                      |               |        |   | n |           |
|                      |               |        |   | e |           |
|                      |               |        |   | d |           |
|                      |               |        |   | F |           |
|                      |               |        |   | T |           |
|                      |               |        |   | E |           |
+----------------------+---------------+--------+---+---+-----------+
| ### Ne               | ### Rene      |        | I |   |           |
| w Appointment/Conver | wal/Extension |        | s |   |           |
| sion/ Pay Adjustment |               |        | t |   |           |
|                      | **Title:**    |        | h |   |           |
| **Proposed Title:**  | [             |        | i |   |           |
| [     ]{.underline}  | ]{.underline} |        | s |   |           |
|                      |               |        | a |   |           |
| **Vice:**            | ### Leng      |        | P |   |           |
| [     ]{.underline}  | th of propose |        | r |   |           |
|                      | d extension [ |        | i |   |           |
| **Proposed T42       |      ]{.under |        | o |   |           |
| Category:**          | line} year(s) |        | r |   |           |
|                      |               |        | i |   |           |
| Intramural (Basic)   | ### Termin    |        | t |   |           |
|                      | al Extension? |        | y |   |           |
| Intramural           |               |        | A |   |           |
| (Clinical)           | Yes (include  |        | c |   |           |
|                      | memo)         |        | t |   |           |
| Senior Scientific    |               |        | i |   |           |
| Leader               | No            |        | o |   |           |
|                      |               |        | n |   |           |
| **Current Band:** I  | **If          |        | f |   |           |
| II III IV            | Rese          |        | o |   |           |
|                      | arch/Clinical |        | r |   |           |
| Clinical Track       | Fellow:**     |        | a |   |           |
|                      |               |        | D |   |           |
| **Proposed Band:** I | Total         |        | i |   |           |
| II III IV            | untenured     |        | r |   |           |
|                      | service       |        | e |   |           |
| Clinical Track       | (including    |        | c |   |           |
|                      | proposed      |        | t |   |           |
| **Current Salary:**  | renewal)      |        | P |   |           |
| \                    | [             |        | a |   |           |
| $[     ]{.underline} | ]{.underline} |        | t |   |           |
|                      |               |        | i |   |           |
| **Proposed Salary:** | **If          |        | e |   |           |
| \                    | Tenure-Track  |        | n |   |           |
| $[     ]{.underline} | In            |        | t |   |           |
|                      | vestigator:** |        | C |   |           |
| **Current Tercile:** |               |        | a |   |           |
| 1 2 3                | Total years   |        | r |   |           |
|                      | in            |        | e |   |           |
| **Current Quartile   | tenure-track  |        | P |   |           |
| (for Band IV         | (including    |        | o |   |           |
| only):**             | proposed      |        | s |   |           |
|                      | renewal)      |        | i |   |           |
| 1 2 3 4              | [             |        | t |   |           |
|                      | ]{.underline} |        | i |   |           |
| ###                  |               |        | o |   |           |
|                      |               |        | n |   |           |
| **Proposed           |               |        | ( |   |           |
| Tercile:** 1 2 3     |               |        | S |   |           |
|                      |               |        | t |   |           |
| **Proposed Quartile  |               |        | a |   |           |
| (for Band IV         |               |        | f |   |           |
| only):**             |               |        | f |   |           |
|                      |               |        | C |   |           |
| 1 2 3 4              |               |        | l |   |           |
|                      |               |        | i |   |           |
| ### R                |               |        | n |   |           |
| ecruitment Incentive |               |        | i |   |           |
|                      |               |        | c |   |           |
| Yes                  |               |        | i |   |           |
| \                    |               |        | a |   |           |
| $[     ]{.underline} |               |        | n |   |           |
|                      |               |        | ) |   |           |
| No                   |               |        | ? |   |           |
|                      |               |        |   |   |           |
| ### Total Pro        |               |        | Y |   |           |
| posed Compensation \ |               |        | e |   |           |
| $[     ]{.underline} |               |        | s |   |           |
|                      |               |        |   |   |           |
| **Additional         |               |        | N |   |           |
| Reviews:**           |               |        | o |   |           |
|                      |               |        |   |   |           |
| NCI Standing         |               |        | N |   |           |
| Committee            |               |        | o |   |           |
|                      |               |        | t |   |           |
| NCC                  |               |        | e |   |           |
|                      |               |        | : |   |           |
| PRP                  |               |        | D |   |           |
|                      |               |        | i |   |           |
| CTC                  |               |        | r |   |           |
|                      |               |        | e |   |           |
| Ethics               |               |        | c |   |           |
|                      |               |        | t |   |           |
|                      |               |        | P |   |           |
|                      |               |        | a |   |           |
|                      |               |        | t |   |           |
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|                      |               |        | n |   |           |
|                      |               |        | t |   |           |
|                      |               |        | C |   |           |
|                      |               |        | a |   |           |
|                      |               |        | r |   |           |
|                      |               |        | e |   |           |
|                      |               |        | p |   |           |
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|                      |               |        | s |   |           |
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|                      |               |        | a |   |           |
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|                      |               |        | s |   |           |
|                      |               |        | s |   |           |
|                      |               |        | h |   |           |
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|                      |               |        | u |   |           |
|                      |               |        | l |   |           |
|                      |               |        | d |   |           |
|                      |               |        | b |   |           |
|                      |               |        | e |   |           |
|                      |               |        | r |   |           |
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|                      |               |        | . |   |           |
|                      |               |        |   |   |           |
|                      |               |        | * |   |           |
|                      |               |        | * |   |           |
|                      |               |        | E |   |           |
|                      |               |        | x |   |           |
|                      |               |        | e |   |           |
|                      |               |        | c |   |           |
|                      |               |        | u |   |           |
|                      |               |        | t |   |           |
|                      |               |        | i |   |           |
|                      |               |        | v |   |           |
|                      |               |        | e |   |           |
|                      |               |        | S |   |           |
|                      |               |        | u |   |           |
|                      |               |        | m |   |           |
|                      |               |        | m |   |           |
|                      |               |        | a |   |           |
|                      |               |        | r |   |           |
|                      |               |        | y |   |           |
|                      |               |        | : |   |           |
|                      |               |        | * |   |           |
|                      |               |        | * |   |           |
|                      |               |        |   |   |           |
|                      |               |        |   |   |           |
|                      |               |        |   |   |           |
|                      |               |        |   |   |           |
|                      |               |        |   |   |           |
|                      |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
|                      | ### A         |        |   |   |           |
|                      | ward \$[      |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Performance   |        |   |   |           |
|                      | Award Special |        |   |   |           |
|                      | Act           |        |   |   |           |
|                      |               |        |   |   |           |
|                      | On the Spot   |        |   |   |           |
|                      | Time Off      |        |   |   |           |
|                      | Other         |        |   |   |           |
|                      |               |        |   |   |           |
|                      | *If OTS or    |        |   |   |           |
|                      | Special Act:* |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Meets         |        |   |   |           |
|                      | criteria on   |        |   |   |           |
|                      | Intangible    |        |   |   |           |
|                      | Benefits      |        |   |   |           |
|                      | Matrix        |        |   |   |           |
|                      |               |        |   |   |           |
|                      | *Impact:*     |        |   |   |           |
|                      | Limited Broad |        |   |   |           |
|                      | General       |        |   |   |           |
|                      |               |        |   |   |           |
|                      | *Benefit:*    |        |   |   |           |
|                      | S             |        |   |   |           |
|                      | mall/Moderate |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Moderat       |        |   |   |           |
|                      | e/Substantial |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Substan       |        |   |   |           |
|                      | tial/Extended |        |   |   |           |
|                      |               |        |   |   |           |
|                      | *If           |        |   |   |           |
|                      | Performance   |        |   |   |           |
|                      | Award:*       |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Current       |        |   |   |           |
|                      | Salary:       |        |   |   |           |
|                      | \$[           |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Percentage of |        |   |   |           |
|                      | Salary:       |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | **HR          |        |   |   |           |
|                      | Information   |        |   |   |           |
|                      | (as           |        |   |   |           |
|                      | applicable)** |        |   |   |           |
|                      |               |        |   |   |           |
|                      | TK #:         |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Supervisor:   |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | CAN:          |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | HNC:          |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
|                      |               |        |   |   |           |
|                      | Supervisory   |        |   |   |           |
|                      | Code:         |        |   |   |           |
|                      | [             |        |   |   |           |
|                      | ]{.underline} |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| ###                  | **Delegated   |        |   |   |           |
|  Retention Incentive | Authority**   |        |   |   |           |
|                      |               |        |   |   |           |
| Renewal              | CCR Deputy    |        |   |   |           |
| \                    | Director      |        |   |   |           |
| $[     ]{.underline} |               |        |   |   |           |
|                      | CCR Director  |        |   |   |           |
| New                  |               |        |   |   |           |
| \                    | NCI Director  |        |   |   |           |
| $[     ]{.underline} | NIH Director  |        |   |   |           |
|                      |               |        |   |   |           |
| **Total Compensation |               |        |   |   |           |
| \$[                  |               |        |   |   |           |
|      ]{.underline}** |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+
| **From:**            |               |        |   |   |           |
| Administrative       |               |        |   |   |           |
| Officer:             |               |        |   |   |           |
| [     ]{.underline}  |               |        |   |   |           |
| ARC:                 |               |        |   |   |           |
| [NCI-Fr              |               |        |   |   |           |
| ederick]{.underline} |               |        |   |   |           |
|                      |               |        |   |   |           |
| Bldg:                |               |        |   |   |           |
| [578]{.underline}    |               |        |   |   |           |
| Rm:                  |               |        |   |   |           |
| [     ]{.underline}  |               |        |   |   |           |
| Phone:               |               |        |   |   |           |
| [     ]{.underline}  |               |        |   |   |           |
| FAX:                 |               |        |   |   |           |
| [301-8               |               |        |   |   |           |
| 46-6053]{.underline} |               |        |   |   |           |
+----------------------+---------------+--------+---+---+-----------+