ACADEMIC RECALL APPOINTMENT FORM

Department Contact Information

Department Contact:
Phone:
Email:
Administrative Comments:
Date:
To:
From:
Department/ORU:
Re: Recall Appointment
Name of Recall Appointee:

Status at Time of Retirement

Department:
Title & Step:
Salary Rate
Pay Basis: 9/9 9/12 11/12
Retirement Date:

Proposed Recall Appointment

Title: Recall Professor (1700)
Research Professor (1702)
Non-Senate Recall: Teaching (1700)
Non-Senate Recall: Research (3802/3812)
Administrative (1702)

Annual Salary:
Dates of Appointment:
Percent Time:
Position Information: Create New Position
Use Existing Vacant Position:
Reason for Recall
Appointment: Professor or Researcher maintains active grants Replacement Teaching Continued work with graduate students Other* (please provide additional information below)
For Teaching Appointments:
*For Academic Administrator appointments requiring EVC approval, please refer to the EVC’s Guidelines

Other Recall Appointments:

Has approval been granted for any other recall appointments during the current fiscal or academic year?
No Yes (If yes, appointment(s) approved as follows)

Title:
Department:
Annual Salary:
Dates:
Percent Time:

Title:
Department:
Annual Salary:
Dates:
Percent Time:

Attach an up to date UC Biography form if there have been changes since the last appointment or time of retirement.

Note: A minimum 30-day break in service after the date of retirement is required prior to any recall to active duty. Recall appointments are limited to a maximum of 43% time per month (or a dollar amount that translates to that equivalent). Departments should advise any academic retiree to consult with the Benefits Office prior to accepting any post-retirement appointment to determine any possible impact on their retirement benefits.

(Last Revised 2/2022)