Attachment 2 1
AGENCY PRE-APPOINTMENT REQUEST CHECKLIST
NON-POLITICAL EXCEPTED 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 Point of Contact (Name, telephone number, email address for follow-up ques
tions)
Name of Proposed Selectee
Current Political Appointee F
o
rmer Political 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
r
oposed Rate of Adjusted Pay (Including Locality)
Political Position (Title, Pay Plan, Series, Grade, and Appointing Authority}
Agency/Component/Office Political Position Held
Rate of Basic Pay as
P
o
litical Appointee
Rate of Adjusted Pay as
Political Appointee
Former Political-Appointment Date of Political
Position
Current Political - Dat
e of Political Appointment
in Agency Currently Employed
Former Political - Ending Date of Political Position
Attachment 2 2
The position descriptions for 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 Evidence of fair and open competition (a recruiting notice, if one was used)
o Description of recruiting sources and advertising methods
o Qualification standard used
o Copy of agency policy for accepting excepted service applications
o Applications from all who applied and information showing how each met or failed to meet
established qualifications
o Information showing how veterans' preference was considered
o The referral list(s) issued to the selecting official and the completed 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.
Please note this Checklist does not apply to:
Appointment of an individual from one Schedule C position to a different Schedule C position or
Movement of an individual from one Presidential appointment to a different Presidential appointment.
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 5001 (Rev. 9/2017)