REQUEST FOR APPROVAL OF NONCOMPETITIVE ACTION
STANDARD FORM 59
Revised January 1979
Office of Personnel Management
296-33
IMPORTANT: See instructions on reverse and detailed instructions in Subchapters S4 and S5,
Appendix A, FPM 296-31
1. Type of Action
Transfer
Position Change
Reinstatement
Temporary or Term
Appointment based
on Reinstatement
Eligibility
Career Appointment
Career Conditional
Appointment
Conversion to Career
or Career-Conditional
Appointment
Appointment (Spec.
Tenure)
Excepted
Appointment
Detail
Other (Specify)
2. OPM Regulation or other authority under which
action is requested
3. Is employee now serving under a career or career
conditional appointment:
Yes
No
(Enter Name, Address, and ZIP Code of OPM Office)
Office of Personnel Management
ATTENTION:
4. Name (Last, First, M.I.)
5. Total length of service in present grade:
6. Home Address -- Complete if employee is to take written test. (Number, Street, City, State, and Zip Code)
No
Yes
7. Veteran Preference
8. Birth Date (Month, Day, Year)
9.
A. Position Title
Pay Plan
Occupational Code
Grade and Salary
FROM
TO
B. Bureau of Office
C. Duty Station
No
Yes
10. Have requirements other than those for which prior approval is requested been met? (Fill out in ALL cases)
(If "No," explain in Item 11, below)
11. Enter (or attach) any supporting statements required by instructions on this form or in FPM Supplement 296-31, Appendix A.
Attach description of duties of proposed position (except where title is descriptive of the duties, such as typist, stenographer, etc.)
A. Prior approval of nominee's experience and training.
12. Reason for Submission (To be checked by agency)
B. Prior approval of action involved:
(1) Waiver of Time-After-Competitive-Appointment restriction under OPM Regulation 330.501.
(2) Waiver of experience and training requirement.
(3) Written Test.
B. (Continued)
(4) A position for which no experience and training standards have been
issued.
(5) A person separated for cause.
(6) Extension of detail beyond 120 days.
(7) Other (Specify):
(Enter Name, Address, and ZIP Code of Requesting Office)
For information call (Name, Telephone No., including Area Code)
Authorized Signature
Title
Date Signed
(Month, Day, Year)
SEE OTHER SIDE FOR OPM ACTION ON THIS REQUEST
59-107
INSTRUCTIONS
NUMBER OF COPIES TO BE SUBMITTED
Submit this form in duplicate.
OFFICE TO WHICH REQUEST IS SUBMITTED
Submit this request to the office which has recruiting jurisdiction over the position involved, except when instructions applicable to the case
(see Subchapters S4 and S5, Appendix A, FRPM Supplement 296-31) require submission to the OPM's central office (for example, all requests
for career appointment based on service in the legislative or judicial branch under section 2(b) or (c) of the Ramspeck Act are submitted to the
Staffing Systems and Services Group, Office of Personnel Management, Washington, D.C. 20415).
SUPPORTING DOCUMENTS AND STATEMENTS
Attach to all requests a completed copy of Standard Form 171 (or 173), Personal Qualifications Statement: except that Standard Form 172,
Amendment to Personal Qualifications Statement, may be used with requests which involve qualification requirements only. (Standard Form
172 may be omitted when the administration of a written test is the only action involved.) Attach any additional documents and include in Item
11 (or attach) any statements required by applicable instructions in Subchapter S4 or S5, Appendix A, FPM Supplement 296-31.
REQUEST INVOLVING SEPARATION FOR CAUSE
State whether the nominee's Official Personnel Folder is in the agency's possession, or has been requested by it.
OPM ACTION
The action proposed on the reverse side of this form is:
Approved
Disapproved (See note below).
The requirements which are checked below were reviewed in making this decision.
Qualifications requirements only
Suitability
Reinstatement eligibility determination
Other (Specify under "Remarks")
Note: The agency must determine whether the individual meets all other requirements for the action proposed.
Remarks:
OFFICE OF PERSONNEL MANAGEMENT
Authorized Signature
Date (Month, Day, Year)