Sf50 Mybiz Details

Form Sf 50 is a document issued by the United States Government to employees who have left their job for any reason. This document confirms that the employee has voluntarily left their position and is not terminated from their job. Form Sf 50 also confirms that the individual's employment record will reflect this departure as a Voluntary Termination. Receiving Form Sf 50 ensures that there are no misunderstandings between you and your previous employer and leaves a clean employment record behind. If you have recently left your job, be sure to request a copy of Form Sf 50 from your former employer as soon as possible.

In the list, there is some good information regarding the form sf 50. You might want to read it before typing in the gaps.

QuestionAnswer
Form NameForm Sf 50
Form Length6 pages
Fillable?Yes
Fillable fields362
Avg. time to fill out36 min 59 sec
Other namessf 50, sf 50 form, what is sf 50 form, sf50 mybiz

Form Preview Example

Standard Form 50

 

 

 

 

 

Rev. 7/91

 

 

 

 

 

 

U.S. Office of Personnel Management

 

 

 

 

 

FPM Supp. 296-33, Subch. 4

NOTIFICATION OF PERSONNEL ACTION

 

 

 

 

 

 

 

 

 

 

 

1. Name (Last, First, Middle)

 

2. Social Security Number

3. Date of Birth

4. Effective Date

 

 

 

 

 

 

 

FIRST ACTION

 

 

 

 

 

5-A. Code

5-B. Nature of Action

 

6-A. Code

6-B. Nature of Action

 

 

 

 

 

 

 

 

 

5-C. Code

5-D. Legal Authority

 

6-C. Code

6-D. Legal Authority

 

 

 

 

 

 

 

 

 

5-E. Code

5-F. Legal Authority

 

6-E. Code

6-F. Legal Authority

 

 

 

 

 

 

 

 

 

7. FROM: Position Title and Number

15. TO: Position Title and Number

8. Pay Plan

9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary

13. Pay Basis

16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award

21. Pay Basis

12A. Basic Pay

12B. Locality Adj.

12C. Adj. Basic Pay

12D. Other Pay

20A. Basic Pay

20B. Locality Adj.

20C. Adj. Basic Pay

20D. Other Pay

14. Name and Location of Position's Organization

22. Name and Location of Position's Organization

EMPLOYEE DATA

23.

Veterans Preference

 

 

 

 

 

 

24.

Tenure

 

25. Agency Use

26.

Veterans Pref. for RIF

 

 

1

- None

3 - 10-Point/Disability

5 - 10-Point/Other

 

 

0 - None

2 - Conditional

 

 

 

 

 

 

 

 

2

- 5-Point

4 - 10-Point/Compensable

6 - 10-Point/Compensable/30%

 

 

1 - Permanent 3 - Indefinite

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27.

FEGLI

 

 

 

 

 

 

 

28.

Annuitant Indicator

 

 

 

29.

Pay Rate Determinant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Retirement Plan

 

 

 

31. Service Comp. Date (Leave)

32.

Work Schedule

 

 

 

33.

Part-Time Hours Per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biweekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pay Period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSITION DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Position Occupied

 

 

 

 

35. FLSA Category

36. Appropriation Code

 

 

 

37.

Bargaining Unit Status

 

 

1

- Competitive Service

3 - SES General

 

 

 

E - Exempt

 

 

 

 

 

 

 

 

 

 

 

 

2

- Excepted Service

4 - SES Career

 

 

 

N - Non-exempt

 

 

 

 

 

 

 

 

 

 

38.

Duty Station Code

 

 

 

 

39. Duty Station (City - County - State or Overseas Location)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40. AGENCY DATA 41.

42.

43.

44.

45. Remarks

46. Employing Department or Agency

Department of Veterans Affairs

47. Agency Code

48. Personnel Office ID

49. Approval Date

VA

50. Signature/Authentication and Title of Approving Official

Human Resources Officer

TURN OVER FOR IMPORTANT INFORMATION

 

Editions Prior to 7/91 Are Not Usable After

5-Part

1 - Employee Copy - Keep for Future Reference

6/30/93

 

NSN 7540-01-333-6236

 

 

NOTICE TO EMPLOYEE

This is your copy of the official notice of a personnel action. Keep it with your records because it could be used

to make employment, pay, and qualifications decisions about you in the future.

The Action

Blocks 5-B and 6-B describe the personnel action(s) that occurred.

Blocks 15-22 show the position and organization to which you are assigned.

Pay

When the personnel action is an award or bonus, block 20 shows the amount of that one-time cash payment. When the action is not an award or bonus, block 12 shows your former total annual salary, and block 20 shows your new total annual salary (block 20C plus 20D). The amount in blocks 12 and 20 do not include any one-time cash payments (such as performance awards and recruitment or relocation bonuses) or payments that may vary from one pay period to the next (such as overtime pay), or other forms of premium pay.

Block 20A is the scheduled amount for your grade and step, including any special salary rate you receive. It does not include any locality-based pay. This rate of pay serves as the basis for determining your rate of pay upon promotion, change to a lower grade, or reassignment, and is used for pay retention purposes.

Block 20B is the annual dollar amount of your interim Geographic Adjustment or, beginning in 1994, your locality-based comparability payment.

Block 20C is your Adjusted Basic Pay, the total of blocks 20A and 20B. It serves as the basis for computing your retirement benefits, life insurance, preimium pay, and severance pay.

Block 20D is the total dollar amount of any Retention Allowances, Supervisory Differentials, and Staffing Differentials that are listed in the remarks block. These payments are made in the same manner as basic pay, but are not a part of basic pay for any purpose.

Block 31 - Service computation Date (Leave)

Shows when your Federal service began unless you have prior creditable service. If so, this date is constructed to include your total years, months and days of prior creditable civilian and military service.

Full-time employees with fewer than 3 years of service earn 4 hours of annual leave each pay period; those with 3 or more years but less than 15 years earn 6 hours each pay period; and those with 15 or more years earn 8 hours each pay period.

Your earnings and leave statement or your time and attendance card will show the rate at which you earn leave and your current unused leave balance.

Block 32 - Work Schedule

Your work Schedule is established by your supervisor.

A full-time employee works on a prearranged scheduled tour of duty that is usually 40 hours per week. A part-time employee has a prearranged scheduled tour of duty that is usually between 16 and 32 hours per week. An intermittent employee has no prearranged scheduled tour of duty and works when needed.

Full-Time and part-time employees whose appointments are for 90 days or more are usually eligible to earn annual leave; intermittent employees are not. Seasonal employees work on an annually recurring bases for periods of less than 12 months each year; they may have a full-time, a part-time, or an intermittent schedule during their work season.

On-call employees work during periods of heavy workload and are in pay status for at least 6 months of each year; they may have either a full-time or a part-time schedule when they are in pay status.

Block 24 - Tenure

Identifies the nature of your appointment and is used to determine your rights during a reduction in force (RIF). Tenure groups are explained in more detail in subchapter 26 of FPM Supplement 296-33 and RIF is explained in FPM Supplement 351-1; both should be available fo review in your personnel office.

Block 26 - Veterans Preference to RIF

Indicates whetehr you have preference for reduction-in-force purposes.

Block 30 - Retirement Plan

FICA

- Social Security System

CS

- Civil Service Retirement System

CS-Spec

- Civil Service Retirement System for law enforcement and

 

firefighter personnel

FS

- Foreign Service Retirement and Disability System

FERS

 

FERS-

 

Reserve

 

Tech

- Federal Employees' Retirement System for National Guard

 

Reserve Technicians

FERS-

 

ATC

- Federal Employees' Retirement System for Air

 

Traffic Controllers

FERS-

 

Spec

- Federal Employees' Retirement System for law enforcement

 

and firefighter personnel

FSPS

- Foreign Service Pension System

Block 33 - Part-time Hours Per Biweekly Pay Period

Indicates the number of hours a part-time employee is scheduled to work during a two-week pay period.

Block 34 - Position Ocupied

Identifies the employment system under which you are serving -- the Competitive Service, the Excepted Service, or the Senior Executive Service (SES).

The employment system determines your eligibility to move to other jobs in the Federal service, your rights in disciplinary and adverse actions, and your eligibility for reemployment if you have Federal service.

Block 35 - FLSA Category

Exempt employees are not covered by the minimum wage and overtime law (the Fair Labor Standards Act); nonexempt employees are covered.

Block 37 - Bargaining Unit Status

Identifies a bargaining unit to which you belong, whether or not you are actually a member of a labor organization. Code "7777" indicates you are eligible but not in a bargaining unit; code "8888" indicates you are ineligible for inclusion in a bargaining unit.

Block 38 and 39 - Duty Station

Identifies the city, county, and state or the overseas location, where you actually work.

OTHER INFORMATION

If your appointment entitles you to elect health benefits or life insurance, and you have not been provided materials explaining the programs available and the enrollment forms, contact your personnel specialist.

Your personnel specialist will also tell you if your position is covered by an agreement between an employee organization (union) and your agency. If you are eligible to and elect to join an employee organization, you can elect to have your dues withheld from your salary.

If you have questions or need more information about your rights and benefits, ask your supervisor or your personnel office.

Definitions for any coded data in Blocks 1-24, 27-39 and 45-50 may be found in Federal Personnel Manuals Supplement 292-1.

It is your responsibility to read all the information on the front of this notice and tell your personnel office

immediately if there is an error in it.

Standard Form 50

 

 

 

 

 

Rev. 7/91

 

 

 

 

 

 

U.S. Office of Personnel Management

 

 

 

 

 

FPM Supp. 296-33, Subch. 4

NOTIFICATION OF PERSONNEL ACTION

 

 

 

 

 

 

 

 

 

 

 

1. Name (Last, First, Middle)

 

2. Social Security Number

3. Date of Birth

4. Effective Date

 

 

 

 

 

 

 

FIRST ACTION

 

 

 

 

 

5-A. Code

5-B. Nature of Action

 

6-A. Code

6-B. Nature of Action

 

 

 

 

 

 

 

 

 

5-C. Code

5-D. Legal Authority

 

6-C. Code

6-D. Legal Authority

 

 

 

 

 

 

 

 

 

5-E. Code

5-F. Legal Authority

 

6-E. Code

6-F. Legal Authority

 

 

 

 

 

 

 

 

 

7. FROM: Position Title and Number

15. TO: Position Title and Number

8. Pay Plan

9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary

13. Pay Basis

16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award

21. Pay Basis

12A. Basic Pay

12B. Locality Adj.

12C. Adj. Basic Pay

12D. Other Pay

20A. Basic Pay

20B. Locality Adj.

20C. Adj. Basic Pay

20D. Other Pay

14. Name and Location of Position's Organization

22. Name and Location of Position's Organization

EMPLOYEE DATA

23.

Veterans Preference

 

 

 

 

 

 

 

24.

Tenure

 

25. Agency Use

26.

Veterans Pref. for RIF

 

 

1

- None

3 - 10-Point/Disability

5 - 10-Point/Other

 

 

0 - None

2 - Conditional

 

 

 

 

 

 

 

 

2

- 5-Point

4 - 10-Point/Compensable

6 - 10-Point/Compensable/30%

 

 

1 - Permanent 3 - Indefinite

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27.

FEGLI

 

 

 

 

 

 

 

 

 

28.

Annuitant Indicator

 

 

 

29.

Pay Rate Determinant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Retirement Plan

 

 

 

31. Service Comp. Date (Leave)

32.

Work Schedule

 

 

 

33.

Part-Time Hours Per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biweekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pay Period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSITION DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Position Occupied

 

 

 

 

35. FLSA Category

36. Appropriation Code

 

 

 

37.

Bargaining Unit Status

 

 

1

- Competitive Service

3 - SES General

 

 

 

E - Exempt

 

 

 

 

 

 

 

 

 

 

 

 

2

- Excepted Service

4 - SES Career

 

 

 

N - Non-exempt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38.

Duty Station Code

 

 

 

 

39. Duty Station (City - County - State or Overseas Location)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40. AGENCY DATA 41.

42.

43.

44.

45. Remarks

46. Employing Department or Agency

Department of Veterans Affairs

47. Agency Code

48. Personnel Office ID

49. Approval Date

VA

50. Signature/Authentication and Title of Approving Official

Human Resources Officer

TURN OVER FOR IMPORTANT INFORMATION

 

Editions Prior to 7/91 Are Not Usable After

5-Part

2 - OPF Copy - Long-Term Record - DO NOT DESTROY

6/30/93

 

NSN 7540-01-333-6236

 

 

Standard Form 50

 

 

 

 

 

Rev. 7/91

 

 

 

 

 

 

U.S. Office of Personnel Management

 

 

 

 

 

FPM Supp. 296-33, Subch. 4

NOTIFICATION OF PERSONNEL ACTION

 

 

 

 

 

 

 

 

 

 

 

1. Name (Last, First, Middle)

 

2. Social Security Number

3. Date of Birth

4. Effective Date

 

 

 

 

 

 

 

FIRST ACTION

 

 

 

 

 

5-A. Code

5-B. Nature of Action

 

6-A. Code

6-B. Nature of Action

 

 

 

 

 

 

 

 

 

5-C. Code

5-D. Legal Authority

 

6-C. Code

6-D. Legal Authority

 

 

 

 

 

 

 

 

 

5-E. Code

5-F. Legal Authority

 

6-E. Code

6-F. Legal Authority

 

 

 

 

 

 

 

 

 

7. FROM: Position Title and Number

15. TO: Position Title and Number

8. Pay Plan

9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary

13. Pay Basis

16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award

21. Pay Basis

12A. Basic Pay

12B. Locality Adj.

12C. Adj. Basic Pay

12D. Other Pay

20A. Basic Pay

20B. Locality Adj.

20C. Adj. Basic Pay

20D. Other Pay

14. Name and Location of Position's Organization

22. Name and Location of Position's Organization

EMPLOYEE DATA

23.

Veterans Preference

 

 

 

 

 

 

 

24.

Tenure

 

25. Agency Use

26.

Veterans Pref. for RIF

 

 

1

- None

3 - 10-Point/Disability

5 - 10-Point/Other

 

 

0 - None

2 - Conditional

 

 

 

 

 

 

 

 

2

- 5-Point

4 - 10-Point/Compensable

6 - 10-Point/Compensable/30%

 

 

1 - Permanent 3 - Indefinite

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27.

FEGLI

 

 

 

 

 

 

 

 

 

28.

Annuitant Indicator

 

 

 

29.

Pay Rate Determinant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Retirement Plan

 

 

 

31. Service Comp. Date (Leave)

32.

Work Schedule

 

 

 

33.

Part-Time Hours Per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biweekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pay Period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSITION DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Position Occupied

 

 

 

 

35. FLSA Category

36. Appropriation Code

 

 

 

37.

Bargaining Unit Status

 

 

1

- Competitive Service

3 - SES General

 

 

 

E - Exempt

 

 

 

 

 

 

 

 

 

 

 

 

2

- Excepted Service

4 - SES Career

 

 

 

N - Non-exempt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38.

Duty Station Code

 

 

 

 

39. Duty Station (City - County - State or Overseas Location)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40. AGENCY DATA 41.

42.

43.

44.

45. Remarks

46. Employing Department or Agency

Department of Veterans Affairs

47. Agency Code

48. Personnel Office ID

49. Approval Date

VA

50. Signature/Authentication and Title of Approving Official

Human Resources Officer

TURN OVER FOR IMPORTANT INFORMATION

 

Editions Prior to 7/91 Are Not Usable After

5-Part

3 - Payroll Copy

6/30/93

 

NSN 7540-01-333-6236

 

 

Standard Form 50

 

 

 

 

 

Rev. 7/91

 

 

 

 

 

 

U.S. Office of Personnel Management

 

 

 

 

 

FPM Supp. 296-33, Subch. 4

NOTIFICATION OF PERSONNEL ACTION

 

 

 

 

 

 

 

 

 

 

 

1. Name (Last, First, Middle)

 

2. Social Security Number

3. Date of Birth

4. Effective Date

 

 

 

 

 

 

 

FIRST ACTION

 

 

 

 

 

5-A. Code

5-B. Nature of Action

 

6-A. Code

6-B. Nature of Action

 

 

 

 

 

 

 

 

 

5-C. Code

5-D. Legal Authority

 

6-C. Code

6-D. Legal Authority

 

 

 

 

 

 

 

 

 

5-E. Code

5-F. Legal Authority

 

6-E. Code

6-F. Legal Authority

 

 

 

 

 

 

 

 

 

7. FROM: Position Title and Number

15. TO: Position Title and Number

8. Pay Plan

9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary

13. Pay Basis

16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award

21. Pay Basis

12A. Basic Pay

12B. Locality Adj.

12C. Adj. Basic Pay

12D. Other Pay

20A. Basic Pay

20B. Locality Adj.

20C. Adj. Basic Pay

20D. Other Pay

14. Name and Location of Position's Organization

22. Name and Location of Position's Organization

EMPLOYEE DATA

23.

Veterans Preference

 

 

 

 

 

 

 

24.

Tenure

 

25. Agency Use

26.

Veterans Pref. for RIF

 

 

1

- None

3 - 10-Point/Disability

5 - 10-Point/Other

 

 

0 - None

2 - Conditional

 

 

 

 

 

 

 

 

2

- 5-Point

4 - 10-Point/Compensable

6 - 10-Point/Compensable/30%

 

 

1 - Permanent 3 - Indefinite

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27.

FEGLI

 

 

 

 

 

 

 

 

 

28.

Annuitant Indicator

 

 

 

29.

Pay Rate Determinant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Retirement Plan

 

 

 

31. Service Comp. Date (Leave)

32.

Work Schedule

 

 

 

33.

Part-Time Hours Per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biweekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pay Period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSITION DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Position Occupied

 

 

 

 

35. FLSA Category

36. Appropriation Code

 

 

 

37.

Bargaining Unit Status

 

 

1

- Competitive Service

3 - SES General

 

 

 

E - Exempt

 

 

 

 

 

 

 

 

 

 

 

 

2

- Excepted Service

4 - SES Career

 

 

 

N - Non-exempt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38.

Duty Station Code

 

 

 

 

39. Duty Station (City - County - State or Overseas Location)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40. AGENCY DATA 41.

42.

43.

44.

45. Remarks

46. Employing Department or Agency

Department of Veterans Affairs

47. Agency Code

48. Personnel Office ID

49. Approval Date

VA

50. Signature/Authentication and Title of Approving Official

Human Resources Officer

TURN OVER FOR IMPORTANT INFORMATION

 

Editions Prior to 7/91 Are Not Usable After

5-Part

4 - Chronological Journal File Copy

6/30/93

 

NSN 7540-01-333-6236

 

 

Standard Form 50

 

 

 

 

 

Rev. 7/91

 

 

 

 

 

 

U.S. Office of Personnel Management

 

 

 

 

 

FPM Supp. 296-33, Subch. 4

NOTIFICATION OF PERSONNEL ACTION

 

 

 

 

 

 

 

 

 

 

 

1. Name (Last, First, Middle)

 

2. Social Security Number

3. Date of Birth

4. Effective Date

 

 

 

 

 

 

 

FIRST ACTION

 

 

 

 

 

5-A. Code

5-B. Nature of Action

 

6-A. Code

6-B. Nature of Action

 

 

 

 

 

 

 

 

 

5-C. Code

5-D. Legal Authority

 

6-C. Code

6-D. Legal Authority

 

 

 

 

 

 

 

 

 

5-E. Code

5-F. Legal Authority

 

6-E. Code

6-F. Legal Authority

 

 

 

 

 

 

 

 

 

7. FROM: Position Title and Number

15. TO: Position Title and Number

8. Pay Plan

9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary

13. Pay Basis

16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award

21. Pay Basis

12A. Basic Pay

12B. Locality Adj.

12C. Adj. Basic Pay

12D. Other Pay

20A. Basic Pay

20B. Locality Adj.

20C. Adj. Basic Pay

20D. Other Pay

14. Name and Location of Position's Organization

22. Name and Location of Position's Organization

EMPLOYEE DATA

23.

Veterans Preference

 

 

 

 

 

 

 

24.

Tenure

 

25. Agency Use

26.

Veterans Pref. for RIF

 

 

1

- None

3 - 10-Point/Disability

5 - 10-Point/Other

 

 

0 - None

2 - Conditional

 

 

 

 

 

 

 

 

2

- 5-Point

4 - 10-Point/Compensable

6 - 10-Point/Compensable/30%

 

 

1 - Permanent 3 - Indefinite

 

 

 

YES

NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

27.

FEGLI

 

 

 

 

 

 

 

 

 

28.

Annuitant Indicator

 

 

 

29.

Pay Rate Determinant

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

30.

Retirement Plan

 

 

 

31. Service Comp. Date (Leave)

32.

Work Schedule

 

 

 

33.

Part-Time Hours Per

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Biweekly

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pay Period

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

POSITION DATA

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34.

Position Occupied

 

 

 

 

35. FLSA Category

36. Appropriation Code

 

 

 

37.

Bargaining Unit Status

 

 

1

- Competitive Service

3 - SES General

 

 

 

E - Exempt

 

 

 

 

 

 

 

 

 

 

 

 

2

- Excepted Service

4 - SES Career

 

 

 

N - Non-exempt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

38.

Duty Station Code

 

 

 

 

39. Duty Station (City - County - State or Overseas Location)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

40. AGENCY DATA 41.

42.

43.

44.

45. Remarks

46. Employing Department or Agency

Department of Veterans Affairs

47. Agency Code

48. Personnel Office ID

49. Approval Date

VA

50. Signature/Authentication and Title of Approving Official

Human Resources Officer

TURN OVER FOR IMPORTANT INFORMATION

 

Editions Prior to 7/91 Are Not Usable After

5-Part

4 - Chronological Journal File Copy

6/30/93

 

NSN 7540-01-333-6236

 

 

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