Form G-1234 (10/06/11) Page 1 of 1
USCIS
Form G-1234
Form G-1234, Probationary Period Requirement
Department of Homeland Security
U.S. Citizenship and Immigration Services (USCIS)
I, , understand that upon entrance on duty to the position,
Date (mm/dd/yyyy)Signed:
(First Name, Middle Name, Last Name)
, , , on
(Title) (Series) (Grade)
, I will be required to serve a probationary period in accordance with the Office of Personnel
Management regulations as put forth in the Code of Federal Regulations Part 315 Career and Career-Conditional Employment.
My rights and entitlements for adverse and disciplinary actions will be processed in accordance with the provisions of the Code
of Federal Regulations Part 315.
(Effective Date)