Standard Form 50
Rev. 7/91
U.S. Office of Personnel Management
FPM Supp. 296-33, Subch. 4
NOTIFICATION OF PERSONNEL ACTION
1. Name (Last, First, Middle)
2. Social Security Number
3. Date of Birth
4. Effective Date
FIRST ACTION
5-A. Code 5-B. Nature of Action
6-A. Code 6-B. Nature of Action
5-C. Code 5-D. Legal Authority
6-C. Code 6-D. Legal Authority
5-E. Code 5-F. Legal Authority
6-E. Code 6-F. Legal Authority
7. FROM: Position Title and Number
15. TO: Position Title and Number
8. Pay Plan 9. Occ. Code 10. Grade or Level 11. Step or Rate 12. Total Salary
13. Pay Basis
16. Pay Plan 17.Occ.Code18. Grade or Level 19. Step or Rate 20. Total Salary/Award
21. Pay Basis
12A. Basic Pay
12B. Locality Adj.
12C. Adj. Basic Pay
12D. Other Pay
20A. Basic Pay
20B. Locality Adj.
20C. Adj. Basic Pay
20D. Other Pay
14. Name and Location of Position's Organization
22. Name and Location of Position's Organization
EMPLOYEE DATA
23. Veterans Preference
24. Tenure
25. Agency Use
26. Veterans Pref. for RIF
1 - None
3 - 10-Point/Disability
5 - 10-Point/Other
0 - None
2 - Conditional
2 - 5-Point
4 - 10-Point/Compensable
6 - 10-Point/Compensable/30%
1 - Permanent
3 - Indefinite
YES
NO
27. FEGLI
28. Annuitant Indicator
29. Pay Rate Determinant
30. Retirement Plan
31. Service Comp. Date (Leave)
32. Work Schedule
33. Part-Time Hours Per
Biweekly
Pay Period
POSITION DATA
34. Position Occupied
35. FLSA Category
36. Appropriation Code
37. Bargaining Unit Status
1 - Competitive Service
3 - SES General
E - Exempt
2 - Excepted Service
4 - SES Career
N - Non-exempt
38. Duty Station Code
39. Duty Station (City - County - State or Overseas Location)
40. AGENCY DATA
41.
42.
43.
44.
45. Remarks
46. Employing Department or Agency
50. Signature/Authentication and Title of Approving Official
Department of Veterans Affairs
47. Agency Code
48. Personnel Office ID
49. Approval Date
Human Resources Officer
VA
TURN OVER FOR IMPORTANT INFORMATION
Editions Prior to 7/91 Are Not Usable After
5-Part
6/30/93
2 - OPF Copy - Long-Term Record - DO NOT DESTROY
NSN 7540-01-333-6236