Fillable Vsip-request-template Request for Voluntary Separation Incentive Payments (VSIP)

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Vsip-request-template Request for Voluntary Separation Incentive Payments (VSIP)

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The Vsip-request-template Request for Voluntary Separation Incentive Payments (VSIP) form is 3 pages long and contains:

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1
Request for Voluntary Separation Incentive Payments (VSIP)
Agency:
Covered Component(s):
1. Identify the time period during which VSIPs may be paid (end date)……………………………..
2. Identify the maximum number of VSIPs to be paid………………………………………………….
3. Identify the maximum amount to be offered (up to $25,000)……………………………………….
4. Describe how the organization will operate without the eliminated/restructured positions and functions. Briefly explain
in 250 words or less.
5. Provide a current and proposed organizational chart showing the expected changes to the
organization’s structure after completing the VSIP plan……………………..……………………………
6. If the agency is requesting, or will request, VERA, briefly describe how that authority will be used in conjunction
with VSIP.
7. If also offering VSIPs under another statutory authority, briefly describe how VSIPs are being used under that authority.
Attached
2
8. In Columns 1 to 3, identify the specific positions that will be eliminated/restructured by organizational unit, geographical location, occupational category, grade level, and any
other factors related to the position such as skills and knowledge gaps you are seeking to address. In Column 5, identify the positions or categories of employees to whom the VSIP
will be offered in order to achieve the reductions/reshaping specified in columns 1 to 3. [NOTE: Column 5 may include additional categories of employees beyond those whose
positions are directly targeted for elimination/restructuring (i.e., positions that are not the main focus for reduction/restructuring/elimination, but which are included in the VSIP
offering only to the extent that they may provide a placement for an employee whose position will be reduced/restructured/eliminated.)] (Attach additional pages as needed)
Positions to be Eliminated/Restructured Positions to be Included in the VSIP Offering
(1)
Organizational
Unit(
s)
(2)
Geographic
Location(s)
(3)
Occupational Category
(i.e., title, series, grade,
and any other position-
related f
actors such as
skills or functions)
(4)
Indicate whether
position(s) will
be eliminated or
restructured
(5)
Scope/Category of employees who will be offered VSIP
Human Resources
Department
Washington, DC
Dallas, TX
Human Resources Assistant,
GS-203-4 (limited to positions
performing transactional
processing work)
Eliminated
Offer will include all positions identified in columns1-3. In addition, the offer will include
the following positions: GS-203-4 positions in the Services Division, limited to positions
that perform transactional processing work, and further limited to those who are
currently eligible for early or regular optional retirement.
3
Agency:
Agency Contact Information & Signature of Requesting Official
Name: Email: Phone:
Name of
Requesting Official:
Title of
Requesting Official:
Signature of Requesting Official
(or attach signed cover memo): ____________________________________________ Date:
________________________________________________________________________________________
OMB Concurrence (OMB Use Only)
Concur Do Not Concur
OMB
Official’s Name:
OMB
Official’s Title:
OMB Official’s Signature: ______________________________________________ Date:
________________________________________________________________________________________
OPM Decision (OPM Use Only)
Approved Disapproved
VSIP
Authorization #:
to
Approval Period: to
Approving
Official’s Name:
Approving
Official’s Title:
Approving Official’s Signature: ___________________________________________ Date:
_________________________________________________________________________________________________
Please submit to:
Mailing Address: Deputy Associate Director
Talent Acquisition and Workforce Shaping
U.S. Office of Personnel Management
1900 E Street, NW
Room 6500
Washington, DC 20415
Email: employ@opm.gov
FAX: 202-606-4430
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Vsip-request-template Request for Voluntary Separation Incentive Payments (VSIP)

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Completed 30 April 2020

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