w Hireransfer ES for Separatin No discretionary benefits authorizedet - PDF document

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llllll New Hireransfer ES for Separatin No discretionary benefits authorizedeturn from OCONUS Non Foreign for SeparationNo discretionary benefits authorizedHouse HuntingripORShipment of POV (must meet minimum mileage Shipment of POV (must meet minimum mileage requirements 10. APPROVALSIGNATUREPRINTED NAME11. APPROVAL - If required by AgencySIGNATUREPRINTED NAMEDefinitions NOTICE UNDER THE PRIVACY ACTFurnishing the information on this form, including your social security number if requested, is voluntary, but failure to do so may not allow Bureau of the Fiscal Service to complete necessary procedures.8. ACCOUNTING (Complete all applicable fields)FUNDPROGRAMINTERNAL ORGCM 3COSTCAM POOLPROJECTCAM 1FOR FISCAL SERVICE USETASKCATB9. COMMENTSIntergovernmental Personnel Act (IPA)Temporary assignment between Federal Govt & state or local govt, institutions of higher education, Indian tribal govt and other eligible organizations. Assignment of no longer than 2 years with possible 2 year extension. Long Term Training (LTT) /Government Employees Training Act (GETA) (5 U.S.C. 4109)Relocation to a new duty station for a temporary training assignment or subsequent return to previous official station upon copletion of training assignment under GETA. No discretionary allowances authorized.Return completed form to Fiscal Service / Relocation Services Branch. Email - pcstravel@fiscal.treasury.gov Fax - 304-551-0351Return from OCONUS Non Foreign for SeparationRelocation to return to place of actual residence for separation. Indicate authorized discretionary benefits in box 9. Temporary Change of Station (TCS)Relocation to a new station for a temporary period of not less than 6 months, nor more than 30 months and subsequent return to previous official station upon completion of assignment. Indicate authorized discretionary benefits in box 11 . SES for SeparationCareer appointee to SES as defined in 5 U.S.C. 3132(a)(4). Indicate authorized discretionary benefits in box 9.New AppointeeIndividual employed with the Federal Govt for the 1st time (includes returning after break in service & student trainee assigned to Govt after completion of college). Indicate authorized discretionary benefits in Box 9. TransferEmployee who transfers from one official station to another (includes within or from another Federal Agency). Indicate authorized discretionary benefits in box 10 . FS Form 5741 Department of the Treasury, Bureau of the Fiscal Service Revised 10/2017The authority for collecting this information is 5 U.S.C. 5701 et seq., and where a social security number is requested, E.O. 9397. The purpose for collecting the information about you is to enable the Bureau of the Fiscal Service to process and record the necessary requirements in connection with your relocation/transfer.This information may be disclosed to agencies, contractors, and others for employment, security, debt collection, computer matching, administration of labor-management programs, and other purposes; a law enforcement agency if the Bureau of the Fiscal Service becomes aware of a possible violation of a law or regulation; a Congressional office to respond to requests by the person to whom the record pertains; courts and counsel during litigation or other proceedings; unions if needed to perform their authorized duties; insurance companies or other appropriate third parties to settle an employee's claim; as otherwise authorized by law or regulation.10. APPROVALSIGNATUREPRINTED NAME11. APPROVAL - If required by AgencySIGNATUREPRINTED NAMEDefinitionsNOTICE UNDER THE PRIVACY ACTurnishing the information on this form, including your social security number if requested, is voluntary, but failure to do so may not allow Bureau of the Fiscal Service to complete necessary procedures.8. ACCOUNTING (Complete all applicable fields)FUNDPROGRAMBFYNTERNAL ORGCM 3COSTCAM POOLPROJECTCAM 1FOR FISCAL SERVICE USETASKCATB9. COMMENTSIntergovernmental Personnel Act (IPA)Te

mporary assignment between Federal Govt
mporary assignment between Federal Govt & state or local govt, institutions of higher education, Indian tribal govt and other eligible organizations. Assignment of no longer than 2 years with possible 2 year extension. Long Term Training (LTT) /Government Employees Training Act (GETA) (5 U.S.C. 4109)Relocation to a new duty station for a temporary training assignment or subsequent return to previous official station upon comtion of training assignment under GETA. No discretionary allowances authorized.Return from OCONUS Non Foreign for SeparationRelocation to return to place of actual residence for separation. Indicate authorized discretionary benefits in box 9.Temporary Change of Station (TCS)Relocation to a new station for a temporary period of not less than 6 months, nor more than 30 months and subsequent return to previous official station upon completion of assignment. Indicate authorized discretionary benefits in box 11 .SES for SeparationCareer appointee to SES as defined in 5 U.S.C. 3132(a)(4). Indicate authorized discretionary benefits in box 9.New AppointeeIndividual employed with the Federal Govt for the 1st time (includes returning after break in service & student trainee assigned to Govt after completion of college). Indicate authorized discretionary benefits in Box 9. TransferEmployee who transfers from one official station to another (includes within or from another Federal Agency). Indicate authorized discretionary benefits in box 10 . FS Form 5741 Department of the Treasury, Bureau of the Fiscal ServiceRevised The authority for collecting this information is 5 U.S.C. 5701 et seq., and where a social security number is requested, E.O. 9397. The purpose for collecting the information about you is to enable the Bureau of the Fiscal Service to process and record the necessary requirements in connection with your relocation/transfer.This information may be disclosed to agencies, contractors, and others for employment, security, debt collection, computer matching, administration of labor-management programs, and other purposes; a law enforcement agency if the Bureau of the Fiscal Service becomes aware of a possible violation of a law or regulation; a Congressional office to respond to requests by the person to whom the record pertains; courts and counsel during litigation or other proceedings; unions if needed to perform their authorized duties; insurance companies or other appropriate third parties to settle an employee's claim; as otherwise authorized by law or regulation.w Hirensfer ES for Separatin No discretionary benefits authorizedeturn from OCONUS Non Foreign for SeparationNo discretionary benefits authorizedHouse HuntingripTemporary Quarters Subsistence ExpenseProperty Management Service Temporary Change of Statoin Intergovernmental Personnel Act (IPA)No discretionary benefits authorizedng Term Training/Gov't Employees Training Act (5 U.S.C. 4109)Request for Relocation - Payment *******SENSITIVE BUT UNCLASSIFIED********MPLOYEEivilian1. TYPE OF RELOCATION - Select type and applicable discretionary benefit(s). Definitions of types are listed on page 2.House Hunting Trip (Not Available on Return from TCS)Temporary Quarters Subsistence ExpenseProperty Management (Not Available on Return from TCS)Extended Storage of HHG2. AGENCY INFORMATIONAGENCYAGENCY CONTACTDIVISIONPHONEEMAIL3. OFFICIAL DUTY STATIONS AND JOB TITLES (Include city and state)OLD DUTY STATIONNEW DUTY STATIONOLD JOB TITLENEW JOB TITLE4. EMPLOYEE INFORMATIONEMPLOYEE SSN (last four)REPORT DATELEGAL NAMEFirst NameMiddle InitialLast Name5. HOME ADDRESS6. MAILING ADDRESS, IF DIFFERENTSTREETSTREETCITYSTATE7. EMPLOYEE CONTACT INFORMATIONWORK PHONE FAX ORShipment of POV (must meet minimum mileage Shipment of POV (must meet minimum mileage requirements requirements and travel commercially for Enroute)and travel commercially for Enroute)Relocation Home Sale ServiceShipment of POV (must meet minimum mileage requirements and travel commercially for Enroute)CITYSTATEHOME PHONE CELL PHONE EMAIL ADDRESS in the moveLINQ Approver Porta