Category II - Request To Modify or Cancel An Existing Fee

Version Dated: 05/23/2022

General Information
Department / College *
Department ID
Division *
Fund Code
Fee Name *
Purpose of the Fee *
Detailed Fee Description
Reason for Changing *
Effective Date Semester Year *
 
Authorization to Submit Request
Division VP / Appropriate Admin.
Division AVP / College Dean
Department Chair / Manager *
ASM *
ASM Phone / Extension *
ASM Email *
 
Contact Information
Contact Name *
Contact Phone / Extension *
Contact Email *
 
Calculation of Fee Level

Last Year Actual
Please note that the reviewer of the request to increase the fee must compare the total actual costs for the previous year as stated on line item (A) to the Actual fee revenue collected in the previous year stated on line (E). Therefore, the excess of actual revenue over actual expenses will not support your request to increase the fee unless adequate explanation / justification is provided, as explained below.

Minimum (Year One) - Needed for all fee requests
Please state the projected cost (and the number of students) for the first year.

Maximum (Year Two) - Needed for all fee requests
Please state the projected cost (and the number of students) for the second year. Usually, the cost during the second year is higher than the first year due to general price increases.

All figures must be rounded to the nearest dollar

Please refer to Financial Documentation for detailed instruction and explanation.

Personnel Services Cost

  Last Year Min (Year 1) Max (Year 2)
Salaries and Wages
Temporary Help Cost
Student Assistants Cost
Staff Benefits Cost
Other Personnel Services Cost
Supplies and Services
Tangible Consumable
Materials
Services
Insurance
Rentals
Other Supplies and Services
Other Costs
Any Other Costs
Description
Total Costs (A) $ $ $
Number of Students/Year (B)
Calculated Cost per Student (C) = A / B $ $ $
Current Fee per Student (D) $
Increase/Decrease in Fee (E) = C - D   From
$ 		To
$
 
What Fee Amount Do You Recommend? Cannot exeed actual cost.
(Please enter 0 to CANCEL this fee) 		$ *
 

Please verify all information.

Please contact us at sfac@csulb.edu if you have any additional questions.