Fill and Sign the Ymca Donation Form

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 FIRST ACTION 3. Date of Birth 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 4. Effective Date 15. TO: Position Title and Number 8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary 12A. Basic Pay 12B. Locality Adj. 12C. Adj. Basic Pay 13. Pay Basis 12D. Other Pay 14. Name and Location of Position's Organization 16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award 20A. Basic Pay 20B. Locality Adj. 20C. Adj. Basic Pay 21. Pay Basis 20D. Other Pay 22. Name and Location of Position's Organization EMPLOYEE DATA 23. Veterans Preference 1 - None 3 - 10-Point/Disability 2 - 5-Point 4 - 10-Point/Compensable 27. FEGLI 30. Retirement Plan 31. Service Comp. Date (Leave) 24. Tenure 25. Agency Use 0 - None 2 - Conditional 1 - Permanent 3 - Indefinite 26. Veterans Pref. for RIF 28. Annuitant Indicator 5 - 10-Point/Other 6 - 10-Point/Compensable/30% 29. Pay Rate Determinant 32. Work Schedule 33. Part-Time Hours Per Biweekly Pay Period 36. Appropriation Code 37. Bargaining Unit Status YES NO POSITION DATA 34. Position Occupied 35. FLSA Category 1 - Competitive Service 3 - SES General 2 - Excepted Service 4 - SES Career 38. Duty Station Code E - Exempt N - Non-exempt 39. Duty Station (City - County - State or Overseas Location) 40. AGENCY DATA 41. 42. 43. 44. 45. Remarks 46. Employing Department or Agency 50. Signature/Authentication and Title of Approving Official Department of Veterans Affairs 47. Agency Code 48. Personnel Office ID VA 49. Approval Date Human Resources Officer TURN OVER FOR IMPORTANT INFORMATION 5-Part 1 - Employee Copy - Keep for Future Reference Editions Prior to 7/91 Are Not Usable After 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 Block 31 - Service computation Date (Leave) 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 24 - Tenure Block 26 - Veterans Preference to RIF Block 30 - Retirement Plan FERSATC FERSSpec FSPS 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. 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. Indicates whetehr you have preference for reduction-in-force purposes. FS FERS FERSReserve Tech Block 32 - Work Schedule Block 33 - Part-time Hours Per Biweekly Pay Period 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. FICA CS CS-Spec 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. - Social Security System - Civil Service Retirement System - Civil Service Retirement System for law enforcement and firefighter personnel - Foreign Service Retirement and Disability System 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 - Federal Employees' Retirement System for National Guard Reserve Technicians 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. - Federal Employees' Retirement System for Air Traffic Controllers - Federal Employees' Retirement System for law enforcement and firefighter personnel - Foreign Service Pension System 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 FIRST ACTION 3. Date of Birth 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 4. Effective Date 15. TO: Position Title and Number 8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary 12A. Basic Pay 12B. Locality Adj. 12C. Adj. Basic Pay 13. Pay Basis 12D. Other Pay 14. Name and Location of Position's Organization 16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award 20A. Basic Pay 20B. Locality Adj. 20C. Adj. Basic Pay 21. Pay Basis 20D. Other Pay 22. Name and Location of Position's Organization EMPLOYEE DATA 23. Veterans Preference 1 - None 3 - 10-Point/Disability 2 - 5-Point 4 - 10-Point/Compensable 27. FEGLI 30. Retirement Plan 31. Service Comp. Date (Leave) 24. Tenure 25. Agency Use 0 - None 2 - Conditional 1 - Permanent 3 - Indefinite 26. Veterans Pref. for RIF 28. Annuitant Indicator 5 - 10-Point/Other 6 - 10-Point/Compensable/30% 29. Pay Rate Determinant 32. Work Schedule 33. Part-Time Hours Per Biweekly Pay Period 36. Appropriation Code 37. Bargaining Unit Status YES NO POSITION DATA 34. Position Occupied 35. FLSA Category 1 - Competitive Service 3 - SES General 2 - Excepted Service 4 - SES Career 38. Duty Station Code E - Exempt N - Non-exempt 39. Duty Station (City - County - State or Overseas Location) 40. AGENCY DATA 41. 42. 43. 44. 45. Remarks 46. Employing Department or Agency 50. Signature/Authentication and Title of Approving Official Department of Veterans Affairs 47. Agency Code 48. Personnel Office ID VA 49. Approval Date Human Resources Officer TURN OVER FOR IMPORTANT INFORMATION 5-Part 2 - OPF Copy - Long-Term Record - DO NOT DESTROY Editions Prior to 7/91 Are Not Usable After 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 FIRST ACTION 3. Date of Birth 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 4. Effective Date 15. TO: Position Title and Number 8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary 12A. Basic Pay 12B. Locality Adj. 12C. Adj. Basic Pay 13. Pay Basis 12D. Other Pay 14. Name and Location of Position's Organization 16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award 20A. Basic Pay 20B. Locality Adj. 20C. Adj. Basic Pay 21. Pay Basis 20D. Other Pay 22. Name and Location of Position's Organization EMPLOYEE DATA 23. Veterans Preference 1 - None 3 - 10-Point/Disability 2 - 5-Point 4 - 10-Point/Compensable 30. Retirement Plan 31. Service Comp. Date (Leave) 26. Veterans Pref. for RIF 29. Pay Rate Determinant 32. Work Schedule 33. Part-Time Hours Per Biweekly Pay Period 36. Appropriation Code 27. FEGLI 24. Tenure 25. Agency Use 0 - None 2 - Conditional 1 - Permanent 3 - Indefinite 28. Annuitant Indicator 5 - 10-Point/Other 6 - 10-Point/Compensable/30% 37. Bargaining Unit Status YES NO POSITION DATA 34. Position Occupied 35. FLSA Category 1 - Competitive Service 3 - SES General 2 - Excepted Service 4 - SES Career 38. Duty Station Code E - Exempt N - Non-exempt 39. Duty Station (City - County - State or Overseas Location) 40. AGENCY DATA 41. 42. 43. 44. 45. Remarks 46. Employing Department or Agency 50. Signature/Authentication and Title of Approving Official Department of Veterans Affairs 47. Agency Code 48. Personnel Office ID VA 49. Approval Date Human Resources Officer TURN OVER FOR IMPORTANT INFORMATION 5-Part 3 - Payroll Copy Editions Prior to 7/91 Are Not Usable After 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 FIRST ACTION 3. Date of Birth 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 4. Effective Date 15. TO: Position Title and Number 8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary 12A. Basic Pay 12B. Locality Adj. 12C. Adj. Basic Pay 13. Pay Basis 12D. Other Pay 14. Name and Location of Position's Organization 16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award 20A. Basic Pay 20B. Locality Adj. 20C. Adj. Basic Pay 21. Pay Basis 20D. Other Pay 22. Name and Location of Position's Organization EMPLOYEE DATA 23. Veterans Preference 1 - None 3 - 10-Point/Disability 2 - 5-Point 4 - 10-Point/Compensable 27. FEGLI 30. Retirement Plan 31. Service Comp. Date (Leave) 24. Tenure 25. Agency Use 0 - None 2 - Conditional 1 - Permanent 3 - Indefinite 26. Veterans Pref. for RIF 28. Annuitant Indicator 5 - 10-Point/Other 6 - 10-Point/Compensable/30% 29. Pay Rate Determinant 32. Work Schedule 33. Part-Time Hours Per Biweekly Pay Period 36. Appropriation Code 37. Bargaining Unit Status YES NO POSITION DATA 34. Position Occupied 35. FLSA Category 1 - Competitive Service 3 - SES General 2 - Excepted Service 4 - SES Career 38. Duty Station Code E - Exempt N - Non-exempt 39. Duty Station (City - County - State or Overseas Location) 40. AGENCY DATA 41. 42. 43. 44. 45. Remarks 46. Employing Department or Agency 50. Signature/Authentication and Title of Approving Official Department of Veterans Affairs 47. Agency Code 48. Personnel Office ID VA 49. Approval Date Human Resources Officer TURN OVER FOR IMPORTANT INFORMATION 5-Part 4 - Chronological Journal File Copy Editions Prior to 7/91 Are Not Usable After 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 FIRST ACTION 3. Date of Birth 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 4. Effective Date 15. TO: Position Title and Number 8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary 12A. Basic Pay 12B. Locality Adj. 12C. Adj. Basic Pay 13. Pay Basis 12D. Other Pay 14. Name and Location of Position's Organization 16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award 20A. Basic Pay 20B. Locality Adj. 20C. Adj. Basic Pay 21. Pay Basis 20D. Other Pay 22. Name and Location of Position's Organization EMPLOYEE DATA 23. Veterans Preference 1 - None 3 - 10-Point/Disability 2 - 5-Point 4 - 10-Point/Compensable 27. FEGLI 30. Retirement Plan 31. Service Comp. Date (Leave) 24. Tenure 25. Agency Use 0 - None 2 - Conditional 1 - Permanent 3 - Indefinite 26. Veterans Pref. for RIF 28. Annuitant Indicator 5 - 10-Point/Other 6 - 10-Point/Compensable/30% 29. Pay Rate Determinant 32. Work Schedule 33. Part-Time Hours Per Biweekly Pay Period 36. Appropriation Code 37. Bargaining Unit Status YES NO POSITION DATA 34. Position Occupied 35. FLSA Category 1 - Competitive Service 3 - SES General 2 - Excepted Service 4 - SES Career 38. Duty Station Code E - Exempt N - Non-exempt 39. Duty Station (City - County - State or Overseas Location) 40. AGENCY DATA 41. 42. 43. 44. 45. Remarks 46. Employing Department or Agency 50. Signature/Authentication and Title of Approving Official Department of Veterans Affairs 47. Agency Code 48. Personnel Office ID VA 49. Approval Date Human Resources Officer TURN OVER FOR IMPORTANT INFORMATION 5-Part 4 - Chronological Journal File Copy Editions Prior to 7/91 Are Not Usable After 6/30/93 NSN 7540-01-333-6236