Financial Agreement number

Pr. Jean-Marc THIRIET

Pr. Jean-Pierre FINANCE

E2 Form for staff-cost declaration

This form was modified thanks to the advises of Victor de Kosinsky, external evaluator.

TIME SHEET EIE-Surveyor REFERENCE POINT FOR ELECTRICAL AND INFORMATION ENGINEERING IN EUROPE 1.Project Nr. 225997-CP-1-2005-1-FR-ERASMUS-TNPP

3^nd year of the project October 2007 – September 2008

In order to justify the staff costs (co-financing), please fill the following document

N.B.1: Please do CERTIFY the staff costs by the account services of your institution, validated with official stamp(s)

N.B.2: Please use as many forms as persons involved

Please fill the following form and send all justifications (original documents or CERTIFIED copy from the account service of your institution) to Mrs Marie-Lise Lemarquis, Université Henri Poincaré, ESSTIN, 2, rue Jean Lamour, F-54519 Vandoeuvre Les Nancy Cedex, France

Name of the institution
Number of the partner^3			Country
Name of the person (please, provide one Time Sheet for each person):
Real yearly salary (including employer's charges, taxes, etc.):
Cost per hour (incl. taxes):

Months