Attachment 1 1
AGENCY PRE-APPOINTMENT REQUEST CHECKLIST
COMPETITIVE SERVICE POSITIONS
Please submit the following information along with a dated cover letter signed by the agency HR Director
certifying that the proposed action meets all merit and fitness requirements in 5 U.S.C. 2301 and 2302 and Civil
Service Rules 4.2 and 7.1.
Requesting Agency
Agency P
oint of Contact (Name, telephone number, email address for follow-up questions
)
Name of Proposed Selectee
Current Political Appointee F
ormer Poli
tical Appointee
Proposed Civil Service Position (Title, Pay Plan, Series, Grade, and Appointing Authority)
Location of Proposed Position (Component/Office)
Proposed Rate of Basic Pay P
roposed R
ate of Adjusted Pay (Including Locality)
Political Position (Title, Pay Plan, Series, Grade, and Appointing Authority}
Agency/Component/Office P
olitica
l Position Held
Rate of Basic Pay as
Politica
l Appointee
Rate of Adjusted Pay as
Political Appointee
Former Political-Appointment Date of Political
Position
Current Political - Date of Poli
tical Appointment
in Agency Currently Employed
Former Political - Ending Date of Political Position
Attachment 1 2
The position descriptions f
or the candidate's current or former political appointment and for the
proposed appointment. Please include a fully executed OF-8 or equivalent showing why and how the
respective positions were established. Explain any relationship between the two positions.
A copy
of the political appointment and resignation/termination SF-50, if available.
An organizational chart identifying where both the political and the proposed positions reside within
the agency or respective agencies.
A statement explaining the disposition of the proposed selectee's current political position, if vacated.
A statement disclosing any personal or professional relationship between the requesting agency' s
recommending and selecting officials (or anyone in the reporting chain) and the proposed selectee.
The complete case file for the proposed merit selection, including:
o The job opportunity announcement(s) published on the USAJOBS website (preferably the USAJOBS
printed version; if not, include the USAJOBS control number)
o A description of recruiting sources and advertising methods used in addition to USAJOBS
o The qualification standard used
o A copy of agency policy for accepting and processing applications
o The job analysis, justification of any selective factor, and rating schedule/crediting plan
o Complete application packages from all applicants (e.g., resumes, questionnaires, DD-214s)
o Documentation of all qualification determinations, how the crediting plan was used to assess each
qualified applicant, and what tie-breaking method was used, if any (rating sheets, etc.)
o Agency correspondence with applicants (e.g., acknowledging receipt, notices of rating)
o Information showing how regulatory requirements of the Interagency Career Transition Assistance
Program (ICTAP) were met
o Documentation of any declinations and/or pass overs and objections
o The certificate of eligibles/referral list(s) issued to the selecting official and the completed
certificate of eligible/referral list documenting the tentative selection
The names of rating/ranking panel members (if applicable) and their titles, telephone numbers, email
addresses, and types of appointment (e.g., career SES, Schedule C, or Presidential Appointee).
The names of the recommending and selecting officials, title, telephone number, email address, and
type of appointment (e.g., career SES, Schedule C, or Presidential Appointee).
Documentation on the interview process, including interview questions and notes, the names of
interviewers/panel members (contact information, type of appointment), and candidates interviewed.
If OPM determines the selection appears to be free from political influence and in compliance with merit system
principles, applicable civil service laws, and regulations, provide the following to PoliticalConversions@opm.gov
:
If appointed to the proposed position, please provide OPM a copy of the appointment SF-50, within 60 days of
appointment, or as soon as practicable.
If not appointed to the proposed position, please notify OPM, within 60 days of the decision, or as soon as
practicable.
OPM 5000 (Rev. 9/2017)