OPTIONAL FORM 5 (Rev. 3/82) 5005-108 Office of Personnel Management FPM Chapter 332 Return this form to > 1. Agency Name and Address ( Number, Street, City, State & ZIP Code) INQUIRY AS TO AVAILABILITY 2. Certificate Number 3. Position Title 4. Salary/Wage 5. Duty Location 6. Type of Appointment Career Conditional (Please correct address, if different from above.) Career Temporary For: Failure to reply to this inquiry will result in the removal of your name from the competitor inventory used to fill this job. This office is considering you along with other eligibles for the position indicated above. Please fill out the "Availability Statement" below, indicating whether you would accept the position if offered, and return this form to this office. Appointment would be subject to the requirements for employment described on the reverse of this form. To be considered for this job, your reply must be received by the date indicated below. If this box is checked, it means your application is not available for review at this time because it is being used elsewhere. If you wish to be considered for this position, complete the enclosed opplication form(s) and return the form(s) with this inquiry. Be sure you have signed the application form(s). THIS IS A LETTER OF INQUIRY ONLY, IT IS NOT AN OFFER OF APPOINTMENT. If you are selected, you will be notified and given further information. O th e r P e rtin e n t J o b In fo rm a tio n : 9. Date Signed (Month, Day, Year ) 8. Signature of Appointing Official 7. Your Reply Must Be Received By: 10. AVAILABILITY STATEMENT The information you give below regarding your availability for employment will be sent to the office which maintains the competitor inventory used to fill this position. If you do not wish to be considered for this job, you must give the conditions under which you will be available for future employment consideration or your name will be removed from the inventory. A. B. days after notification. I am available for the above position. If selected, I can report for duty within I do not wish to be considered for the above position for the following reason(s): (year, month, day, or hour) or be at least grade 1. 2. Location—I am available for work only in 3. I will not be available until 4. I do not wish to be considered for vacancies with this agency. 5. I no longer wish to be considered for any position under the examination program/announcement which covers the above position. 6. I no longer wish to be considered for Federal employment. 7. C. Grade/Pay—The position must pay at least $ Other—I am giving my reason on the back of this form. per (date--month, day, year). I am available for consideration for other appointments requiring: (In each category, check as many as apply.) 1. OVERNIGHT TRAVEL 1 to 5 nights per month 6 to 10 nights per month 11 or more nights per month 11. Your Signature and Date Signed (Month, Day, Year) NSN 7540-00-634-4262 2. PART TIME 16 or less hours per week 17 to 24 hours per week 3. TEMPORARY 25 to 32 hours per week Telephone number where you can be reached Monday through Friday between 9 a.m. and 4 p.m. (SEE OTHER SIDE) 1 2. Area Code American LegalNet, Inc. www.FormsWorkFlow.com Less than one month 1 to 4 months 5 to 12 months Number Edition dated 4/79 is usable. REMARKS: INFORMATION FOR ELIGIBLES DESCRIPTION OF APPOINTMENTS Appointments are of three types.— Temporary, career-conditional, and career. Temporary appointments are limited to one year or less. Career-conditional appointments are normally given when the positions are not temporary and confer civil service status upon completion of a one-year probation. These appointments are converted to career appointments after three years of substantially continuous service. Career appointment is given from lists of eligibles only when the eligible selected has already met the service requirements for career appointment, or when the position is one which is required by law to be filled on a permanent basis. APPOINTMENTS ARE SUBJECT TO THESE REQUIREMENTS 1. Before you can be appointed to arduous, hazardous or heavy duty positions you will be requested to pass a medical exam. Before appointment to most sedentary, light or moderate duty positions, you will be required to complete a medical questionnaire, in lieu of a medical exam. Therefore, even if you are selected for a position, you are cautioned not to resign from your present position until you receive specific instructions to report to work. These instructions are usually received after the physical examination has been completed or the medical certificate approved. 2. All eligibles selected for appointment will be subject to investigation, including fingerprinting, for the purpose of inquiring into qualifications, suitability, and fitness for the position and to verify the statements made in the application f o r m s. OTHER INFORMATION Suspension of eligibility/availability.— Your name will be re- notified of and respond to reasons submitted by the agency moved from the active competitor inventory when you (1) are proposing his/her passover within 15 days of the date of such unable to accept an appointment and request that your name notification. The names of all eligibles not selected will be be removed, (2) indicate you are unwilling to accept a job and restored to the list of eligibles, provided they are still availado not indicate interest in further consideration for employble for appomtment. The fact that you were not selected will ment, (3) fail to reply to this inquiry or other official inquiry not affect your opportunities to be considered for other concerning your availability for Federal employment, or (4) positions for which you qualify. when you are selected for a career-conditional or career Equal employment policy.— Under Public Law 93-261, Execuappointment. tive Order 11478, Public Law 93-259 as amended, and the Office of Personnel Management regulations, all personnel Restoration of eligibility/availability.— You may request to have actions taken by Federal appointing officers shall be based your name restored to the active inventory anytime during solely on merit and fitness. If your name is referred to a the one year following the suspension of your eligibility. Federal department or agency for consideration for employWhen you request restoration you should either (1) specify ment and you feel you are discriminated against because of the type of position(s), grade level(s), and numerical rating your race, religion, color, national origin, sex, or age, except received, if any, or (2) attach a photocopy of your notice of when age limits have been established by the Office of rating or letter of acceptance to the request. Your request Personnel Management after determining that the age is a should include any changes in the conditions under which bona fide qualifications requirement necessary to perform the you will accept appointment if these conditions have duties of the position or when age limits have been estab changed. You will be notified if your name cannot be relished under the provisions of special laws, you may consult turned to the competitor inventory and considered for referwith an Equal Employment Opportunity (EEO) Counselor in ral in accordance with the conditions under which you stated that department or agency. The names and locations of EEO you would be available. Counselors are required to be posted permanently at the Office of Equal Employment Opportunity in every Federal Procedures followed when you are nonselected.— When you replv department or agency personnel office. The counselor will to an official inquiry and indicate that you are available for advise you of your rights and assist you in every way possible. the position if offered, you will be considered along with all other available eligibles. The appointing officer may select Cost of transportation.— If selected, you must pay all transporany one of the three highest available applicants. The aptation costs connected with reporting for duty, except for pointing officer may not, however, pass over an eligible positions for which a manpower shortage exists. The appointentitled to veteran preference and appoint a nonpreference ing officer will advise you if the position for which you have eligible unless the reasons for passing over the preference been selected is one for which the agency will pay transportaeligible are considered sufficient. The preference eligible tion costs. If you should subsequently fail to meet the rewho is passed over is entitled to review the reasons why quirements to which the appointment is subject, or if your he/she was not selected. A preference eligible with a servlceemployment is terminated for any reason, you must pay for connected disability of 30 percent or more is entitled to be your return also. U.S. Government Printing Office: 1988—201-760/80040 American LegalNet, Inc. www.FormsWorkFlow.com