AO 425 Pre-Employment Information
Before employment, the following HR form has to be completed and submitted in order to provide the required information for the hiring process.
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AO 425 (Rev. 11/92) Pre-Employment Information SECTION A: 1. Name (Last, First, Middle): \ , \ , Previously Used Name(s): 2. Social Security Number: 3. Date of Birth: 4. Requesting Agency Name and Address: 5. Name of Person Requesting Information: Phone Number: SECTION B: 1. Currently employed Separated (Specify Date) 2. Agency Name and Location of Official Personnel Folder (complete address): 3. Grade/Level Step/Rate Salary Pay Basis 4. If Salary Includes Coast of Living Adjustme nt (COLA), Indicate Base Salary and COLA Base: COLA: 5. Service Computation Date (SCD) 6. Retirement Plan If retirement code is C, E, 1, or 6: Date First Covered If retirement code is K or M: Elected FERS Automatically covered Date First Covered SECTION C—RETIREMENT DATA 1. MILITARY: A. Branch of Service B. Retired Rank C. Check One and Specify Date: Retired Transferred to Fleet Reserve (Date) 2. FEDERAL CIVILIAN: A. Civilian Retirement Date B. Retirement System Paying Annuity SECTION D—GRADE AND PAY DATA 1. Date Entered Current Grade and Step/Rate 2A. Date of Last Within-Grade Increase (WGI) 2B. If WGI Was Denied, Date of Denial 3A. Highest Previous Grade/Step Held 3B. Dates Held: From: To: Salary: 4. Was Salary Based on Special Rate or Locality? Yes No 5A. Is Applicant on Grade Retention? Yes No 5B. Retained Grade/Step: 5C. Date Grade Retention Began 6. Is Applicant on Pay Retention? Yes No 7. If Not Listed Above, Highest Sala ry Held on a Federal Appointment Dates Held: From: To: SECTION E—APPOINTMENT DATA 1. Is there an INS Form I-9 on file? Yes No (Date Certified) 2. Is the applicant a U.S. citizen? Yes No If No, list country citizen of (SEE REVERSE) SECTION F—UNFAVORABLE DATA 1. Does OPF Contain Removal, Suspension, Within-Grade Denial, Discharge or Change to Lower Grade Actions? Yes No (Type of Action) 2. Is There Unfavorable Information in Other Files, e.g. Letters of Warning, Admonishment, Reprimand, Suitability or Letter of D ecision on an Adverse Action? Yes No Don’t Know 3. If “Yes” to Question 1 or 2, Name and Phone Nu mber of Person to Contact for More Information: SECTION G—BENEFITS DATA (HEALTH INSURANCE, LIFE INSURANCE) 1. FEHB (Health) Waived Canceled—Show Date: Ineligible Enrolled—Show Code: 2. FEGLI (Life) Enrollment Code If “B” Waived—effective date SECTION H—SERVICE OBLIGATION 1. Does OPF Show Employee Has an Obligation to Remain in Gove rnment Service for a Specific Period Because of Training Received? No Yes—Date Obligation Expires: 2. Does Employee Have an Obligation Because of a Government-Paid Move? No Yes—Date Obligation Expires: SECTION I—PAYROLL & THRI FT SAVINGS PLAN DATA 1. A. Employees Payroll Office Address: B. Leave Balances: Annual SickIs Employee Currently on LWOP? No Yes—Beginning Date: NTE Date: C. Person to Contact for Leave and Pay Information: (Na me) (Phone Nu mber) 2. Year-To-Date FICA Deductions $ As Of: (Date) 3. Does Employee Have Severance Pay Entitlement? No Yes—Beginning Date: 4. Thrift Savings Plan A. TSP SCD B. TSP Vesting Code C. TSP Status Code D. TSP Status Date 5. TSP Allocation A. Percent of Base Pay— .00% B. Whole $ Amount— .00 C. G Fund Government Securities Investment— .00% D. F Fund Fixed Income Index Investment— .00% E. C Fund Common Stock Index Investment— .00% Total— 100 .00% 6. Year-To-Date TSP Contributions $ 7. TSP Loan Account Number: Payroll Deduction Account: 8. Name and Title of Official Certifying TSP Information SECTION J—LOSING AGENCY RELEASE DATE 1. A. Requested Release Date: B. Name and Phone Number of Person to Call For Release Date 2. Name, Title, and Phone Number of Person Giving Information (Name) (Phone Number) (Name) (Title) \ (Phone Number) (Name) (Title)
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