Part A
Item 1.
Personnel Actions Requested - Indicate action requested. If temporary,
also indicate the duration, e.g., not to exceed (NTE) one year.
Item 2. Request Number - Leave blank. The Office of Human Resources Management will complete.
Item 3. For Additional Information - Provide the name and telephone number of the individual who can discuss the personnel action with a Human Resources Specialist if additional information is required.
Item 4. Proposed Effective Date - Leave Blank
Item 5. Requested By - The official requesting the action should sign and date this line.
Item 6. Authorized - The approving official will sign and date the form except when the requesting official and the approving official is the head of the organization. In that case, only Item 6 is required.
Part B
The originating office should complete the following items in this section: (If recruitment request, go to block 15)
Item 7. From: Position Title and Number - Identify only the Position Title. The position number will be assigned by the Personnel Specialist.
Item 8 & Item 9. Pay Plan and Occupational Code - Enter the current pay plan and the current occupational code, (e.g., GS-0318)
Item 10. Grade or Level - Enter the current grade level of the position.
Item 15. - TO: Position Title and Number - Identify only the Position Title. The position number will be assigned by the Human Resources Specialist.
Item 16 & 17. Pay Plan and Occupational Code - Enter the proposed pay plan and the proposed occupational code, if known (e.g., GS-1140). If you do not have this information, the personnel specialist will complete it for you.
Item 18. Grade or Level - Enter the proposed grade level(s) of the position, e.g., GS-9/11/12.
Item 22. Name and Location of Employing Office - Indicate the exact location of the position within the established organization (e.g., International Trade Administration, Trade Development, DAS for Tourism Industries).
Item 36. Appropriation Code - This item is to be completed by the originating office in accordance with the ITA Financial Coding Pattern for the current fiscal year.
Part C
This section will be completed by the Human Resources Specialist.
Part D
Remarks By Requesting Office - This space is provided for comments, special instructions, and/or information management may feel is necessary to convey to the Office of Human Resources Management. Completion of this item is optional.
PART E
This section is only applicable for employee resignations and retirements.
PART F
This section will be completed by the Human Resources Specialist.
For additional information contact: your Servicing Human Resources Specialist 202-482-3301.