Certification of Service Performed as a Law Enforcement Officer, Firefighter, Nuclear Materials Courier,
Customs and Border Protection Officer (535 Service), or Air Traffic Controller
Instructions
This certification form must be completed by an agency official authorized to certify an employee’s service in one of these special population categories: law
enforcement officer (LEO), firefighter (FF), nuclear materials courier (NMC), customs and border protection officer (535 Service) (CBPO), and air traffic controller
(ATC). The agency official must complete this form whenever an employee who has performed service in one of these special population categories with the agency
separates (for any reason) from that agency.
•
File the completed certification form on the permanent side of the employee’s Official Personnel Folder (OPF) if the separation is for a reason other than
retirement or death.
•
Forward the certification form, and any other such certification forms that may be already on file in the OPF, to the Office of Personnel Management if the
separation is for retirement or death.
•
Make separate entries for each unique period of service described in the list of special population codes below. For example, if an employee performs a period
of service as a law enforcement officer in a rigorous position and then transfers to a secondary law enforcement position that is qualifying for retirement under
the law enforcement provisions in 5 U.S.C.
§ 8412(d), one entry should document the period of rigorous service and a second entry should document the
secondary service.
•
Enter the appropriate Special Population Code from the list below to document the type of service for each entry. For example, enter “01” to document service
in a primary/rigorous law enforcement officer position, “02S” to document service in a qualifying secondary-supervisory firefighter position, and “13S” to
document service as an air traffic controller second level supervisor.
•
Provide the position description number for all service types except for air traffic controller service. The position description number is not needed for entries
documenting air traffic controller service.
Note: Certification of CBPO “535” service (that is service subject to the provisions of Section 535 of Division E of the Department of Homeland
Security (DHS) Appropriations Act, Public Law 110-161, approved 12/26/2007) may be made only by an appropriate authorized official of the
Department of Homeland Security.
Special Population Category Special Population Codes
Primary/
Rigorous
Secondary-
Administrative
Secondary-
Supervisory
Law Enforcement Officer 01 01A 01S
Firefighter 02 02A 02S
Nuclear Materials Courier 03 03A 03S
CBPO (535 service) - Appointed on or after July 6, 2008 17 17A 17S
CBPO (535 service) Proportional - Appointed before July 6, 2008, and served as a CBPO on July 6, 2008 17P 17AP 17SP
Air Traffic Controller - Frontline Service (as defined in 5 U.S.C. § 2109(1)(A)(i)) 13
Air Traffic Controller - Other - Preflight/Inflight/Airport Advisor Service (as defined in 5 U.S.C. § 2109(1)(A)(ii)) and First Level Supervisor
(as defined in 5 U.S.C. § 2109(1)(B))
13X
Air Traffic Controller - Second Level Supervisor (as defined in 5 U.S.C. §§ 8331(30)(B) and 8401(35)(B)) 13S
RI 20-124
September 2012
