Fillable Userra Return To Duty Technician Checklist printable pdf download

UNIFORMED SERVICES EMPLOYM ENT AND REEMPLOYM ENT RIGHTS ACT

US ERRA RETURN TO DUTY TECHNICIAN CHECKLIS T

The USERRA Return To Duty (RTD) Technician Checklist assists Idaho National Guard Federal Employ ees who entered military service in

ABSENT – UNIFORM ED SERVICES to understand and determine what elections and options are available to them at the time they RTD from

military service. This checklist, a Standard Form (SF) 52 (Request for Personnel Action), and a copy of military orders (if available)/DD-214 or

compatible notification from the M ilitary Unit stating a release from military service must be completed and submitted to the Joint Force

Headquarters, Human Resources Office in Building 442 for appropriate processing.

You are required to initial all applicable blocks to indicate your elections and that you have read and understand your options/conditions.

I. INDIVIDUAL INFORMATION

1. Name:

2. SSA N:

3. Technician Unit:

4. Pay Plan-Series-Grade:

5. Ho me Address:

6. C ity:

7. State:

8. Z ip :

9. Phone Nu mber:

10. Email:

II. RETURN TO DUTY (RTD)

This section identifies the date and intent of your return status, whether physically or administratively. Returning Technicians must understand all

RTD prerequisites.

Validity of Discharge

You must provide military orders or documentation such as your DD-214 which indicates you were discharged or pending discharge from military

service under honorable conditions. If you are unable to provide ANY documentation prior to or upon your RTD, the HRO will still honor your

request. However, you are still obligated to provide the agency proof on the validity and type of discharge at a l ater time. If your documentation

indicates your discharge is under other than honorable conditions, you are subject to a denial of reemploy ment or be terminated from employment.

Restoration Periods

Upon release from military service, you have a specific time limit to report back to your technician position once released from your Military Orders:

1) Less than 30 days, must report back to work at the beginning of the next regularly scheduled workday after release.

2) M ore than 30 but less than 181 days, must notify supervisor no later than 14 days after release.

3) M ore than 180 days, must notify supervisor no later than 90 days after release.

Terminal Leave/Transition Leave

If you are on terminal/transition leave pending separation from or release from military service (under honorable conditions), you can elect to RTD

and receive your technician pay in addition to the unexpired portion of your military service.

Initials

Select and initial your election and includ e an effective date.

I ELECT to Return To Duty. I have been released or am pending release fro m

Effective Date:

military service under honorable conditions and within the time period(s) listed

above.

PRESIDENTIAL LEAVE

III.

Technicians returning from Title 10 military duty in support of (OCO) Overseas Contingency Operations such as Operations Enduring Freedom,

New Dawn, Noble Eagle, or any military operation subsequently established under Executive Order 13223 are granted five days of excused

absence each t ime Techn icians RTD from such military service.

Eligibility

(1) You must have spent at least 42 or more consecutive days in active military service. An accumulation of 42 or more days with breaks does not

constitute eligibility for the Five Day Excused Absence.

(2) The Five Days Excused Absence is limited t o one time p er every 12-month period which begins on the first day of the excused absence and ends

365 days later.

Conditions of use

(1) You must use the Five Day Excused Absence at the time you RTD and prior to your actual resumption of your duties. You will RTD

administratively and will report physically to work following the five days.

(2) You must use the Five Day Excused Absence cons ecutively and cannot save it for a later date or use it cumulatively on s eparate days. If, you

are/were un able to us e the excused absence at the time of your RTD, you may request and schedule the excused absence at a t ime mutually

agreeable to you and your supervisor.

(3) You must coordinate with your Supervisor and/or Time & Attendance Representative for approval and submission of your excused absence.

Initials

Select and Initial ONLY ONE:

I DID NOT S ERVE IN S UPPORT OF

OPERATION.

I understand the Presidential Leave conditions and requirements and will make the necessary coordination for its use.

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USERRA RTD Technician Checklist

Userra Return To Duty Technician Checklist

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