Form Usfj Form 11ej-Personnel Action Request / Official Notification Of Iha Personnel Action

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PERSONNEL ACTION REQUEST / OFFICIAL NOTIFICATION OF IHA PERSONNEL ACTION
人事措置要求書/諸機関労務協約公式人事措置通知書
For IHA employees, this is an official notification of the action described below which affects your employment. Keep this notice. Promptly
call any error to the attention of your supervisor.
IHA従業員の方は、この書面があなたの雇用に関する下記の人事措置についての公式通知書になります。
この通知書は保管しておいてください。書面に誤りがあった時にはあなたの上官に直ちに知らせてください。
1. NAME (Last, First - Mr. or Ms.)
1A. DATE OF BIRTH
2. EMPLOYEE NO.
3. REQUEST NO.
氏 名
生年月日
従業員番号
要求番号
4. NATURE OF ACTION REQUESTED
5. REQUESTED EFF DATE 6. DATE OF REQUEST
要求措置の性質
人事措置発効要求日
要求日
FROM:
自
7. TYPE OF CONTRACT AND EMPLOYMENT
TO:
至
MLC
MC
IHA
MLC
MC
IHA
契約区分及び雇用種類
8. JOB TITLE, JOB NO., BWT, GRADE, AND STEP
職種名、職番、基本給表、等級及び号棒
￥
￥
9. BASIC WAGE
基本給
10. ORGANIZATIONAL UNIT
組織名
11. INSTALLATION
施設名
AREA
LEVEL
12. COMPETITIVE AREA AND LEVEL
AREA
LEVEL
競合地域及びレベル
13. WORK CONDITIONS AND SCHEDULE
雇用条件及び勤務時間
A. PERIOD OF EMPLOYMENT
雇用の期間：雇用の開始日から
月
年
日限り
B. TRIAL PERIOD
: If you are hired as a trial period employee, you will become a permanent employee upon successful completion of your
試用期間
trial period.
試用期間従業員として雇用された場合、試用期間を問題なく終了した後に常用従業員となります。
　,
　　
:
hrs.
C. WEEKLY WORK DAYS AND HOURS
週労働日、労働時間
:
:
:
STARTING TIME
ENDING TIME
TO
.
RECESS
始業時間
終業時間
休憩時間
:
D. DESIGNATED NON-WORK DAY AND REST DAY
(Dates designated by work schedule
)
休日
就業計画により指定された日。
E. INTERMITTENT
Yes
No
断続交代勤務の有無　：
有
無
F. DUTY OUTSIDE OF SCHEDULED WORKWEEK HOURS
:
Yes
No
所定時間外の勤務
有
無
: As prescribed under the MLC, the MC, and the IHA.
G. SEPARATION
雇用の終了
基本労務契約、船員契約及び諸機関労務協約の規定による。
14. REMARKS
その他
15. APPROPRIATION DATA AND FS-UU-CE CODES
16. REQUESTED BY (TYPED NAME AND TITLE):
16a. SIGNATURE
16b. DATE
16c. TEL
17b. DATE
17c. TEL
17. CO OR AUTHORIZED REPRESENTATIVE
(TYPED NAME AND TITLE):
17a. SIGNATURE
18. CLEARANCES
INITIALS
DATE
INDORSEMENT BY COR (for MLC/MC)
OR AUTHORIZED CPO/HRO REPRESENTATIVE (for IHA)
契約担当官代理
米軍人事部
19.
ABOVE ACTION IS APPROVED BY:
20. SIGNATURE
21. DATE
地方防衛局/地方防衛事務所
INDORSEMENT BY RDB/RDO
22. PERSONNEL ACTION TAKEN
23. EFFECTIVE DATE
24. REMARKS (If any)
25. SIGNATURE OF CHIEF RDB/RDO
26. DATE
USFJ FORM 11EJ, 20120315
THIS FORM IS SUBJECT TO THE PRIVACY ACT OF 1974.
PREVIOUS EDITIONS ARE OBSOLETE.

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