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CHAPTER 14
APPENDIX A
MILITARY SPOUSE PPP SELF-CERTIFICATION CHECKLIST
IMPORTANT: This form must be submitted with your application each time you
apply to a Department of Defense (DoD) position on USAJOBS in order to receive
Military Spouse Preference.
Applicant’s Name:
Military Sponsor’s Name:
Date of Marriage to Military Sponsor:
Military Sponsor’s Last or Current Duty Station:
Military Sponsor’s New (or Future Sequential) Duty Station:
Date of relocation or anticipated relocation to Sponsor’s New Duty Station:
INSTRUCTIONS - Read items 1-12 and click on each “Choose an Item”. Choose the
words from the drop-down menu that best describes your status as a military spouse.
Completion of each item is verification that you have read and understand that the
information you provide is truthful and can be used to help to verify your eligibility as a
military spouse preference applicant. A new self-certification checklist must be submitted
with each application and must be dated within the last 30 days. Upon completion of this
form, we recommend saving a copy to your USAJOBS account for future use.
1. I a U.S. Citizen.
2. an active duty military member of the U.S. Armed Forces
(including the U.S. Coast Guard and full- time National Guard or Reserve).
3. My sponsor’s Permanent Change of Station (PCS) orders in
conjunction with retirement or separation from active duty.
4. I that preference only applies to positions within the
commuting area of my sponsor’s current permanent duty station.
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5. I that loss of spousal status due to divorce, death of my sponsor,
or my sponsor’s retirement or separation from active duty will result in terminating my
eligibility for spouse preference.
6. I that the acceptance or declination of a temporary position does
not impact my priority placement status. “Temporary” positions include:
a. Positions filled by temporary or term appointment, including Non-
Appropriated Fund (NAF) time-limited appointments, regardless of duration
or work schedule;
b. Positions filled by permanent appointment with intermittent or seasonal
work schedules; and
c. NAF positions with a “flexible” work schedule, or any NAF position for
which the employment category is identified as “flexible.”
7. I that I am only eligible for preference for ONE job offer of a
permanent position. A “permanent position” is defined as a Federal appropriated or
non-appropriated position which has a fixed full-time or part-time work schedule.
8. I that accepting or declining a permanent position will result in
terminating my eligibility for military spouse preference at my current location.
9. I received a job offer for a permanent position within the
commuting area of my military sponsor’s current permanent duty station.
10. I currently occupying a permanent appropriated or non-
appropriated position at the current duty station.
11. I on a telework agreement with my current Federal job that allows
me to work for them on a permanent basis after relocating to my military sponsor’s
current duty station.
12. I had on-the-job performance or conduct problems within the last
12 months.
Certification Statement: I, certify that I have
read and understand the information contained in this self-certification checklist and my
responses are accurate and truthful.
Date:
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Documents that may be required to be submitted with each application: (Note: DoD
agencies may require some or all of these documents. Please refer to the job announcement
to ensure all required documentation is submitted with your application. It is highly
recommended that you save all these documents to your USAJOBS account in order to
facilitate applying to multiple positions.
Military Spouses without prior Federal work experience
o Narrative resume
o PCS orders
o Marriage certificate or license
o Signed self-certification checklist
o Veteran’s preference documentation (e.g., DD-214, VA letter,
o Statement of Service), if applicable
o Transcripts, if applicable
Military Spouses with prior Federal work experience
o Narrative resume
o PCS orders
o Marriage certificate or license
o SF-50s, if applicable (e.g., LWOP, highest grade held, overseas
appointments, etc.)
o Documentation of performance rating of record (dated within the last 12
months), if applicable
o Signed self-certification checklist
o Veteran’s preference documentation (e.g., DD-214, VA letter, Statement of
Service), if applicable
o Transcripts, if applicable
PRIVACY ACT STATEMENT: Sections 1301, 3302, 3502 of Title 5, U.S. Code
provide for the issuance of rules governing the competitive service and authorize
solicitation of this information.
Gaining and releasing activities use this information to place registrants, report actions,
and update data as well as refer names to potential employers or to provide information to
you about potential employment. Furnishing the requested information is voluntary, but
failure to provide it may result in missed opportunity for proper placement or
reemployment under the respective placement assistance program.