Fillable Charter Inc. Employee Resume Template (Page 2 of 2) in pdf

HQ F 3293.1 (1-12)

All Other Editions are Obsolete

INSTRUCTIONS

PART I - Items 1-5 (Employee or Employee Organization)

Completed by the employee and/or the office to which the employee is assigned

PART II - Item 6 (Employee)

Complete the DOE Form 3250.1 (10-07) – U.S. Department of Energy Exit Interview and attach to this form.

PART III - Item 7 (Administrative Officer, HQ Security Officer and Records Liaison Officer)

7a. Administrative Officer (AO) signs upon completing:

7b. HQ Security Officer (HSO) signs upon completing:

Collection and transfer sensitive property items

Verify ID Badge submission

to another person or office, as appropriate

Terminate area, building and special access

Collection of RSA Token, office keys, purchase

Change safe combinations

and travel charge cards, calling cards, etc.

Follow security procedures for TS Documents

Cancellation of LAN and Email accounts

Collection of Secure Telephone(s)

Notifying the Occupational Health Units

7c. Records Liaison Officer (RLO) signs upon transfer of Federal records to person assuming responsibility or to RLO.

PART IV - Items 8-12 (Employee)

Hand-carry this form, on or prior to the last day of active duty, to the offices listed.

Item 8 applies only to employees required to file Financial Disclosures

o SF-278 is required for all separating employees that are paid at an SES (or equivalent) rate or above

and worked 60 days or more in the preceding year

o OGE-450 is required for all separating employees who have filed a financial statement and are not

required to file an SF-278

Item 9 applies to all employees

Item 10 applies to all employee enrolled in the Transit Subsidy Program (SEET)

Item 10 applies to all employees with (or listed on) a parking permit for the DOE HQ garage

Item 12 applies only to employees issued a passport by DOE (or other agency) for work-related travel

PART IV - Item 13 (Employee)

Hand-carry this form, on the last day of active duty, to the Badge Office. Security will issue temporary access

credentials for the remainder of the work day. Turn in Security Badge and receive Security Debriefing.

PART IV - Item 14 (Employee)

This should be the last clearance. Employee meets with his/her servicing personnel office (i.e., DOE, NNSA, SC, OIG)

for Exit Interview and Benefits Debriefing.

DOE (including Retiring Employees) -

NNSA – Room F-125, Germantown

Room GM-169, Forrestal

SC – G-Wing, 2

Floor, Germantown

NNSA – Room GB-157, Forrestal

OIG – Room 5D-031, Forrestal

UPON COMPLETION, RETURN THIS FORM TO THE ADMINISTRATIVE OFFICER

Administrative Officer – if the employee has a financial or property obligation, submit a copy of this form to the Payroll and

Budget Execution Team (CF-11; Room C-248, Germantown; or FAX to (301) 903-3916) by the separation date for salary offset.

PRIVACY ACT STATEMENT

Public Law 95-91 (The Department of Energy Organization Act) authorizes the collection of this information. The information requested in this form is

intended for the use of agency officials and managers to release obligations which might have been incurred by the employee during employment.

Completion of this form is voluntary. However, if the employee fails to complete the form, his/her final paycheck may be delayed.

Charter Inc. Employee Resume Template Page 2

Related Articles

Related forms

Related Categories