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3330 43 Form PDF Details

This blog post will provide information on the 3330 43 form, which is a request for an income tax withholding certificate. This form can be used by employees to change their current status and determine how much money should be withheld from their paycheck. If you are interested in learning more about this form and how it works, please continue reading! For those of you who want to know more about the 3330-43 Form, read on as we discuss what this document is and why it’s important to have one.

In the listing, there is some information in regards to the 3330 43 form. It's going to give you the estimated time it would take you to complete the form and several extra details.

Question	Answer
Form Name	3330 43 Form
Form Length	4 pages
Fillable?	Yes
Fillable fields	290
Avg. time to fill out	29 min 32 sec
Other names	faa form 3330 43, faa 3330 43 1, fillable faa form 3330 43, faa form 3340 43

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RATING OF

AIR TRAFFIC EXPERIENCE

IMPORTANT

Read the following instructions carefully

before filling out this application.

•You must furnish all requested information. The information you provide will be used to

determine your qualifications and rating. Do

not submit a resume in lieu of completing this form.

•If you fail to answer all questions fully and accurately, you may lose employment opportunities.

•So that it is understood that you did not omit an item, please write the letters "N/A" (not applicable) beside those items that do not apply to you.

•Read the vacancy announcement for the position advertised to be certain that your experience and education meet the requirements.

•Be sure to include all forms required.

-FAA Form 3330-42, Request for Promo- tion Consideration & Acknowledgement.

-FAA Form 3330-43, Rating of Air Traffic Experience.

-DOT Form 3430-7, Performance Appraisal Form.

-Any other information required by the position vacancy announcement.

•Incomplete applications will be rejected.

•Submit the above along with a stamped envelope, addressed as directed in the vacancy announcement, to your rating official on or before the vacancy closing date.

Detailed instructions for filling out this form appear on the next page.

PRIVACY ACT REQUIREMENTS (P.L. 93-579)

This form is used to determine qualifications and is authorized under Title 5 of the U.S. Code, Sections 3302 and 3361. It must b e submitted in order for you to be considered for the position being advertised. The Information will be used for FAA personnel-related purposes and will not be transmitted outside the agency except as provided by law. Providing the information requested on this form is not mandatory, but if you fail to give us the complete data, we cannot give you a rating. We must have your Social Security Number (SSN) to keep your records straight, because other people may have the same name.

FAA Form 3330-43 (10/11)

Electronic Version (Adobe)

i

PRIVACY ACT NOTICE APPEARS ON REVERSE

INSTRUCTIONS

Rating Of Air Traffic Experience

Please Read the Instructions Below Before Completing This Form

Do not make any entries in the shaded areas. They are reserved for the rating official. The TALLY is also for the rating officials use. The upper right corner of the form to the VACANCY ANNOUNCEMENT. Enter the appropriate

information exactly as it appears on the vacancy announcement.

If you need more space than has been provided for a given item, continue on an 8 ½ x 11” sheet of paper with the items numbered to correspond to the items continued. Place your name and vacancy number in the upper right corner and attach to the form.

Candidate Information.

Self-explanatory

Selective Placement Factors

Check the appropriate box. Candidates who have not satisfied appropriate selective placement factors are not qualified for the vacancy.

TALLY

For use of Rating Official Only Use Tally to record values for each factor. Add up the total score and enter it in the box at top right of form.

FACTORS 1 and 2-Career ProgressionExperience and Diversity

a. Position title, grade, and performance level. List all civilian Air Traffic experience beginning with your entrance on duty. Make a separate entry for each official detail or temporary position. Do not list military experience. Enter your performance level using abbreviations: e.g. Regional Office (RO): Headquarters (HO): Trainee (TR): Developmental (DEV): Journeyman (J), etc.

b. Facility Identifier. Enter the three-letter identifier for the facility to which you were assigned.

c. Facility type. ARTCC; FSS; CS/T; CAB; Radarcab (R/C); Radar Approach Control (RAC). Enter the acronym for the facility type on the line with the position title.

d.Facility Level. Enter the facility level.

e.Facility/area rating. Enter the date (month, day, year) you received your rating. Identify whether area

(a)and/or facility (f)

f. & g. Dates: From/To. Enter the month. day, and year you started in the position and the date you left; e.g. from 6/23/78 to 12/19/78.

h.Creditable time (Cred. Time). Enter the number of full months officially assigned to the position. Do not count incomplete months; e.g., 1-17 through

2-16 and 1-17 through 3-15 are both counted as on

(1) month.

i. FACTOR 1 - Career Progression Experience (CPE). Enter the CPE points for the highest valued position currently or previously held by the candidate. CPE points are credited for one (1) position only. If the candidate has encumbered several positions which meet this criterion, the rating official will review the entire application and select the position which most benefits the candidate (a minimum of 1 year service is required to receive credit for a position. See Paragraph 10).

j. Factor 2- Diversity (DIV). Credit the DIV points for appropriate positions held by the candidate (see Paragraph 11d for Diversity Table).

FACTOR 3- Current Performance Appraisal

Attach your current Performance Appraisal Form (DOT Form 3430.7) to the application. This must be the current regular performance appraisal document. No other form is acceptable. (See paragraph12)

FACTOR 4 - Career Performance Recognition.

This factor credits awards and recognition not related to the current performance appraisal document. List each outstanding rating (O), exceptional rating (E), quality step increase (Q), special achievement award (SA), letter of commendation (COM), o r suggestion award (SUG) received and the date you received it. QSI’s and SA”s given in conjunction with an outstanding rating are given credit for the rating only (see paragraph 13)

FACTOR 5- Committee Participation.

Fill in the appropriate committee participation. Be sure that the month, day, and year are entered in the “From” and "To'" blocks (see paragraph 14).

FACTOR 6 - Education and Self-Development. Complete all appropriate items in this factor (see paragraph 15).

FACTOR 8- Other pertinent factors.

List appropriate items as required by vacancy an- nouncement. Rating official refer to the vacancy announcement for point schedule (see paragraph

16)

Resumes may be attached, if desired, but not in lieu of completing this form.

FAA Form 3330-43 (10/11)

Electronic Version (Adobe)

ii

Score of

Rating of Air Traffic Experience

Candidates

TALLY

Vacancy Number

Vacancy Position Title

Series and Grade

FACTOR

Max.

Score

Pts.

1

75

Vacancy Closing Date

Facility

Location/Region

2

65

3

25

Name of Candidate

Present Series, Grade, and Location

Social Security Number

4

10

5

6

Current Supervisor

Location/Region

Office Phone Number

6

25

7

20

Selective Placement Factor

Not

Satisfied

Not

Total Score

Satisfied

Applicable

FACTORS 1 and 2 - Career Progression Experience and Diversity

Value

Position, Title, Grade and

Facility

Level

Dates(Mo/Day/Yr)

Cred

1

2

Performance Level

ID

Type

Area/FAC

From

To

Time

CPE

DIV

(a.)

(b.)

(c.)

(d.)

(e.)

(f.)

(g.)

(h.)

(i.)

(j.)

(1)

(2)

(3)

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

(12)

(13)

(14)

(15)

(16)

(17)

(18)

(19)

FAA Form 3330-43 (10/11)

Electronic Version (Adobe)

1

Factor 3 - Current Performance Appraisal (Attach DOT Form 3430.7)

Outstanding	Outstanding	Exceptional	Fully Successful	Max 25 Points
Rating With QSI	Rating	Rating	Rating
25pts.	20pts.	10pts.	5pts.
Factor 4 - Career Performance Recognition				Total Factor 4
				(Maximum10)

Type

Date

Value

Type

Date

Value

Type

Date

Value Type

Date

Value

O = Outstanding Rating	SA = Special Achievement Award
Q = Quality Step Increase	COM = Ltr. Of Commendation
E = Exceptional Rating	SUG = Suggestion Award

Factor 5 - Committee Participation (Maximum 1 point per committee)		Enter Committee Name	Total Factor 5
Must have at least 1 year of service to receive credit.		and Dates Served	(Maximum 6)

Committee

Dates Served		Point
(mm/dd/yy)
From	To

Committee

Dates Served		Point
(mm/dd/yy)
From	To

Factor 6 - Education and Self-Development

6a. Credit undergraduate college work at 30 semester hours or 45 quarter credits = 1 year. Credit graduate college work at 18 semester hours or 27 quarter credits = 1 year. Education in increments of less than 1 year may be prorated in half-year increments in accordance with the following table. Award credit only for the highest level attained by the applicant. Circle appropriate credit.

COLLEGE EDUCATION CREDIT TABLE

1 Year of college – 3				4 yrs. Of college - 9
1.5 yrs. Of college - 4				Bachelor’s Degree* - 10
2 years of college - 5				1 year of graduate work - 12
Associate’s Degree - 6				2 yrs. Of graduate work - 14
2.5 yrs. Of college - 6				Master’s Degree* - 15
3 years of college - 7				3yrs. Of graduate work - 17
3.5 yrs. Of college - 8				Doctorate* - 20
*Type of Degree:	Date:	School:

6b. FAA Correspondence Courses		6c. Long-Term Training
List Course Titles and Dates			Date Completed
			(5 Points)
Completed on Separate Sheet		Factor 6 Grand Total
and Attached to Application
Total	6b	6a	6b	6c	(Max 25)
(Maximum4)
Factor 7 - Other pertinent factors
(Must be identified in vacancy announcement. Use separate sheet of paper.)				(Maximum 20)
				(Maximum 20)

CERTIFICATION OF CANDIDATE: I certify that all of the statements made in this application are true, complete, and correct to the best of my knowledge and belief and are made in good faith.

CERTIFICATION OF RATING OFFICIAL: I certify that this rating is true, complete, and correct to the best of my knowledge and belief.

Date

Signature of Candidate

Date

Signature of Rating Official

FAA Form 3330-43 (10/11)

Electronic Version (Adobe)

2

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