United States Department of Agriculture
Research, Education, and Economics
ARS * CSREES * ERS * NASS
Policies and Procedures
Title: | Employee Exit Clearance Procedures |
Number: | 426.1 |
Date: | October 22, 1998 |
Originating Office: | Human Resources Division, REE Policy Branch, AFM/ARS |
This Replaces: | |
Distribution: | All REE Employees |
This P&P establishes procedures for all employees,
both permanent and temporary, who transfer to another agency, resign, retire,
or otherwise
separate from an REE agency. *As of 10/05/2004, the Attachment 4, USDA Form AD-1126, Exit Interview Questionnaire, has been abolished by the Department. REE also will no longer use the questionnaire. Thus, Attachment 4 (AD-1126) to Directive 426-1 is no longer valid for use and is removed from the directive. This directive will be updated at a later date. |
Table of Contents
1. Policy
2. Liabilities
3. The Separation Process
4. Summary of Responsibilities
Attachment 1
Attachment 2
Attachment 3a
Attachment 3b
Attachment 4
When an employee separates from ARS, CSREES, ERS, or NASS, the respective agency must ensure that the employee either returns or accounts for any outstanding financial liabilities and/or accountable items for which the employee is responsible. Each agency, in coordination with Administrative and Financial Management's (AFM), Human Resources Division (HRD), must follow a coordinated set of actions to complete check-out procedures before the employee leaves the agency. These requirements may be supplemented, but not replaced.
A financial liability is an employee debt that includes monies owed for travel expenses and advances, advanced leave, service or training agreements, etc. An accountable items liability includes any Government-owned items for which an employee is responsible; i.e., official records, charge cards, passports, ID cards, laptop computers, home use equipment, or other assigned personnel property, electronic access cards, etc. Prior to separation, each employee is responsible for returning accountable items and monies owed.
If the employee cannot account for all items or if the employee owes money to the Government, the employee must arrange for settlement of these items. If a settlement arrangement is not agreed upon, Agency Administrators may request that HRD initiate collection action against the employee for an outstanding debt or loss of property.
Any employee planning to leave the agency should notify his or her supervisor as soon as possible, preferably 2 weeks in advance of the separation date. By giving an advance notice, post-employment matters can be resolved quickly and efficiently. Upon notification, administrative representatives (i.e., supervisors, HRD representatives, location administrative officers, administrative officers, Area personnel office staff, Area personnel assistants, or others who may have administrative responsibility), must contact the employee personally to conduct the exit process. (If practical, discussions should be in person; however, neither past nor present supervisors are permitted to discuss or collect information for the completion of the AD-1126, USDA Exit Interview Questionnaire (Attachment 4), with the employee. The administrative representative must also complete and/or provide the employee with the following documents:
Administrators
Director, Human Resources Division (HRD)
Director, Procurement and Property Division (PPD)
Director, Financial Management Division (FMD)
Director, Information Technology Division (ITD)
REE Safety Officers, ARS Area Administrative Officers, and Location Administrative Officers
Administrative Representatives
Employees
/s/
W. G. HORNER
Deputy Administrator
Administrative and Financial Management
REE-9 (9/98) SEPARATION FORMS CHECKLIST |
|||
INSTRUCTIONS: The HRD staff is responsible for completing and filing this form. Administrative representatives who initiate any of these processes are encouraged to complete relevant sections and include with other materials submitted to HRD for processing. | |||
TYPE OF DOCUMENT |
DATE COMPLETED |
DATE SENT TO HRD |
DATE SENT TO EMPLOYEE |
. GENERAL FORMS | |||
REE-10 Employee Exit Checklist | |||
AD-1126 USDA Exit Interview Questionnaire | |||
SF-50-B Notification of Personnel Action | |||
SF-293 Notice to Separated Employee . . . Disposition of OPF | |||
AD-349/1024 Employee (Change of ) Address | |||
AD-435 Performance Appraisals | |||
AD-491 Security Debriefing Secrecy Agreement | |||
AD-581 Lump Sum Leave or Compensatory Time Payments | |||
AD-717 Audit for Leave Year(s) ____ | |||
AD-815 Post Employment Restriction Notice | |||
. RETIREMENT FORMS | |||
SF-2802 Application for Refund of Retirement Deductions CSRS | |||
SF-2808 Designation of Beneficiary CSRS | |||
SF-3102 Designation of Beneficiary FERS | |||
SF-3106 Application for Refund of Retirement Deductions FERS | |||
TSP-BK01 TSP Withdrawal Information (Employee Package) | |||
. LIFE INSURANCE FORMS | |||
SF-2819 Notice of Conversion Privilege FEGLI Program | |||
SF-2821 Agency Certification of Insurance Status FEGLI Program | |||
. HEALTH INSURANCE FORMS | |||
FEHB TCC Letter | |||
SF-2809-A FEHB, Federal Employees Health Benefits Program | |||
RI79-27 Temporary Continuation of Coverage (TCC) under FEHB | |||
SF-2810 Notice of Change in Health Benefits Enrollment | |||
. UNEMPLOYMENT FORMS | |||
SF-8 Notice to Federal Employee About Unemployment Insurance | |||
FRICK-U88Z UCFE Frick Company Employee Separation Form |
Signature_____________Date____________
NOTE: File Completed Sheets Only -- OPF (Left Side)
REE-10 (9/98) U.S. Department of Agriculture |
|||||||
1.
EMPLOYEE |
2. ORGANIZATIONAL UNIT | 3. SEPARATION DATE | |||||
INSTRUCTIONS: The administrative representative is responsible for ensuring that all items in Parts I - VI are checked. Any items marked as no under cleared should be identified in Part VII. The administrative representative must obtain authorization and signatures for all items listed in Part VII. Once the status of all items has been resolved, the administrative representative completes Part VIII and forwards this form to AFM, Human Resources Division. | |||||||
ITEM | ACTION |
CLEARED | CLEARED
THRU |
SIGNATURE |
DATE | ||
---|---|---|---|---|---|---|---|
YES | NO | N/A | |||||
PART I - ADMINISTRATIVE | |||||||
1. Leave Audit (AD-717) | Complete and forward to HRD. | ||||||
2.
Lump-Sum Payments ( AD-581) |
Complete and forward to HRD. | ||||||
3. Official Listings (Phones & Other Directories) | Complete
AD-349 and/or AD-1024. |
||||||
4. Last T&A | Timekeeper must mark the last T&A as final if leaving USDA. | ||||||
5.
Retirement Forms ( ARS Field Only) |
Mailed SF-2802,SF-2808, SF- 3106, SF-3201, TSP-BK01. | ||||||
6. Life Insurance Forms (ARS Field Only) | Mailed SF-2819 & SF-2821. | ||||||
7.
Health Insurance Forms (ARS Field Only) |
Mailed/delivered
TCC Letter, RI 79-27, SF-2810. |
||||||
8.
Unemployment Form (ARS Field Only) |
Mailed/delivered SF-8. | ||||||
9.
Performance Plan (NASS Only) |
Forward NASS PRP Form 435B to HRD. | ||||||
10.
AD-1126, Exit Questionnaire |
Collect and forward to HRD. | ||||||
PART II - IDENTIFICATION/PROPERTY | |||||||
1.
USDA Photo ID Card |
Collect and submit to AO/LAO or HRD in HQ. | ||||||
2.
Lock-up Pass |
Collect
and destroy (ERS return to COS). |
||||||
3.
Official Government Passport and/or Visa |
Return to the retention office for cancellation. | ||||||
4.
Accountable Property (Computers, Cell Phones, Home Use Equipment, etc.) |
All
property has been returned. Contract warrants have been terminated. Passwords/IDs have been terminated. |
||||||
5.
Other Accountable Items (Keys, Manuals, etc.) Transit Subsidy - ERS Only |
All accountable items have been returned to supervisor or designated representative. | ||||||
6. Reference Materials (Smart Ctr., Library, etc.) | All reference materials have been returned. | ||||||
7.
Personal Protection and Safety and Health (ARS Only) |
Check with AO/LAO and Safety Officer to ensure compliance and to clear equipment. | ||||||
8. Electronic Access Card(s) (Building, Elevator, Parking, etc.) | Collect and return to AFM/FD or to AO/LAO for ARS field offices. | ||||||
Part III - FINANCIAL | |||||||
1. Travel Advance | Check with designated agency travel office. | ||||||
PART IV - SERVICE AGREEMENTS | |||||||
1. First
Duty Station/ Relocation Bonus |
Verify that agreement has been fulfilled. | ||||||
2. Transfers/ Relocations/Bonus | Verify that agreement has been fulfilled. | ||||||
3.
Long-Term Training (1890, Math Stat, etc.) |
Verify that agreement has been fulfilled. | ||||||
PART V - CHARGE CARDS | |||||||
1. Travel Charge Card | Return to the employee's supervisor or designated representative. | ||||||
2. PCMS Purchase Card | ARS & CSREES - return to AFM/FMD. NASS & ERS - return to agency budget office. ITD - Cancel Password and IDs | ||||||
3. Supply
Cards (Central Supply Store - HQ) |
Return to AFM/PPD. | ||||||
4. FTS 2000/ International Calling Card | Return to AFM/ITD. | ||||||
PART VI - SECURITY | |||||||
1. Debriefing | Obtain signatures on AD-491. | ||||||
2. ADP Access | ARS -
Contact ACS/DCS or ITD help desk. CSREES, ERS, NASS - Contact LAN/E-mail administrator. |
||||||
3. NFC Access | ARS/ACS and CSREES - contact ITD help desk; ERS - ADP Security Officer; NASS - Agency Security Officer | ||||||
4. Classified Materials | Arrange with ITD to change safe and door combinations. | ||||||
5. Official Records | Supervisor must make sure records have not been removed. | ||||||
6. Office Doors, Files, Desk Keys | Arrange with AFM/FD (AO/LAO for ARS field) to change locks, return keys, etc. | ||||||
7. Official Authorizations | Rescind employee's authorization to act for the agency (e.g. property passes, imprest fund, open travel authorizations, etc.) | ||||||
PART VII - ITEMS NOT CLEARED (LIST SPECIFIC STATUS AND ACTION(S) TO BE TAKEN) | |||||||
ITEM |
STATUS |
ACTION |
SIGNATURE OF AGENCY HEAD (OR DESIGNEE) |
||||
1. | [ ]Waive [ ]Collect | ||||||
2. | [ ]Waive [ ]Collect | ||||||
PART VIII - TO BE COMPLETED BY THE RESPONSIBLE ADMINISTRATIVE REPRESENTATIVE ONCE ALL ITEMS HAVE BEEN CHECKED | |||||||
Typed Name and Title: |
ISSUES TO DISCUSS WITH EMPLOYEES WHO ARE
SEPARATING FROM FEDERAL SERVICE
1. HEALTH BENEFITS COVERAGE
2. LIFE INSURANCE
3. THRIFT SAVINGS PLAN
4. SICK LEAVE
5. ANNUAL LEAVE/COMP LEAVE/CREDIT LEAVE
6. REFUND OF RETIREMENT
7. PAYROLL CHANGE
8. MISCELLANEOUS ISSUES: The following issues should be explained if they apply to the separating employee:
ISSUES TO DISCUSS WITH EMPLOYEES WHO ARE
MOVING TO ANOTHER USDA AGENCY
1. HEALTH BENEFITS COVERAGE
2. LIFE INSURANCE
3. THRIFT SAVINGS PLAN
4. ANNUAL & SICK LEAVE
5. COMP LEAVE & CREDIT LEAVE
6. PAYROLL CHANGE
7. MISCELLANEOUS ISSUES: The following issues should be explained if they apply to the separating employee:
The Attachment 4 USDA Form AD-1126, Exit Interview Questionnaire, has been abolished by the Department. REE also will no longer use the questionnaire. Thus, Attachment 4 (AD-1126) to Directive 426-1 is no longer valid for use and is removed from the directive. This directive will be updated at a later date.
AD-1126, USDA EXIT INTERVIEW QUESTIONNAIRE
Instructions: We ask each employee who leaves the agency to provide feedback
about his or her employment. This information will enable us to identify where
improvements should be made in various agency programs and/or work practices. Your
participation is voluntary.
All responses are kept confidential.
Part I - Reasons for Leaving: [ ]ARS
[ ]CSREES [ ]ERS [ ] NASS (Please
check one.) |
Indicate which best describes how important each of the following
reasons was in your decision to leave the organization. Please circle ONE response for
each.
1
- Important 2 - Neither Important nor Unimportant 3 - Unimportant |
(REASONS FOR LEAVING) | |||
1. Desire to pursue non-work interests | 1 | 2 | 3 |
2. Desire change to different type work | 1 | 2 | 3 |
3. Desire to earn more money | 1 | 2 | 3 |
4. Desire to continue formal education | 1 | 2 | 3 |
5. Desire a move to different location | 1 | 2 | 3 |
6. Desire to work close to home | 1 | 2 | 3 |
7. Desire to advance career | 1 | 2 | 3 |
8. Desire more meaningful work | 1 | 2 | 3 |
9. Retirement benefits | 1 | 2 | 3 |
10. Health benefits | 1 | 2 | 3 |
11. Leave benefits | 1 | 2 | 3 |
12. Changes to retirement | 1 | 2 | 3 |
13. Reorganization | 1 | 2 | 3 |
14. Inconsistent policies | 1 | 2 | 3 |
15. Management/employee cooperation | 1 | 2 | 3 |
16. Organization becoming too political | 1 | 2 | 3 |
17. Working conditions/safety | 1 | 2 | 3 |
18. Working hours/shifts | 1 | 2 | 3 |
19. Opportunity to participate in decisions | 1 | 2 | 3 |
20. Red tape | 1 | 2 | 3 |
21. Job stress | 1 | 2 | 3 |
22. Personal health problems | 1 | 2 | 3 |
23. Difficulties in getting adequate day care | 1 | 2 | 3 |
24. Training | 1 | 2 | 3 |
25. Opportunities for advancement | 1 | 2 | 3 |
26. Promotional practices | 1 | 2 | 3 |
27. My job was moved geographically | 1 | 2 | 3 |
28. Management wanted to fire or demote me | 1 | 2 | 3 |
29. Support, e.g., equipment, etc. | 1 | 2 | 3 |
30. Recognition | 1 | 2 | 3 |
31. Morale of work group | 1 | 2 | 3 |
32. Relationship with supervisor | 1 | 2 | 3 |
33. Discrimination based on sex, race, age, etc. | 1 | 2 | 3 |
34. Other: ____________________________ | 1 | 2 | 3 |
35. Of the reasons listed above, what was your number one (1) reason for leaving?___ (Give the number) | 1 | 2 | 3 |
Part II - General attitude about your Agency/Department: |
Indicate which best describes your feelings about the following
factors. Please circle ONE response for each.
1 - Strongly Satisfied 2 - Satisfied 3 - Neither Satisfied or Dissatisfied 4 - Dissatisfied 5 - Strongly Dissatisfied |
1. Agency's policies or procedures | 1 | 2 | 3 | 4 | 5 |
2. Cooperation and participation between managers/ supervisors/ employees | 1 | 2 | 3 | 4 | 5 |
3. Ability to communicate, discuss, and resolve concerns
and complaints with supervisors or managers |
1 | 2 | 3 | 4 | 5 |
4. Working conditions (e.g., space, heat, furniture, equipment, support, etc.) | 1 | 2 | 3 | 4 | 5 |
5. Opportunity to participate and utilize skills on task
forces, collateral duty or detail assignments |
1 | 2 | 3 | 4 | 5 |
6. Training and development opportunities | 1 | 2 | 3 | 4 | 5 |
7. Opportunities for advancement | 1 | 2 | 3 | 4 | 5 |
8. Promotion practices | 1 | 2 | 3 | 4 | 5 |
9. How the discrimination process based on race, color, gender, age, national origin, disability, political affiliation, religion, marital, or family status is handled | 1 | 2 | 3 | 4 | 5 |
10. How sexual harassment issues are handled | 1 | 2 | 3 | 4 | 5 |
11. Fair and equal recognition for work accomplishments | 1 | 2 | 3 | 4 | 5 |
12. Organizational changes or reorganization | 1 | 2 | 3 | 4 | 5 |
13. Other factors: |
A. Would you return to the Agency? | Yes ____ | No ____ |
B. Would you recommend the Agency to a friend as a good place to work? | Yes ____ | No ____ |
C. Were you satisfied with your work experience at your Agency? | Yes ____ | No ____ |
D. Could anything have been done to prevent you from leaving? | Yes ____ | No ____ |
(If yes, please explain.) Explainations/Comments:_______________________________________ ___________________________________________________________ ___________________________________________________________ |
Part III - Data Analysis Information (Strictly voluntary): |
Your responses to these questions are important. The information will be used
for analysis and descriptive purposes only. Your responses to the questions will not be
separated out individually.
A. PAY SYSTEM: | [ ] GS/GM | [ ] WG/WL/WS | [ ] ES | [ ] OTHER | |
B. PAY GRADE RANGE: | [ ] 1-5 | [ ] 6-8 | [ ] 9-12 | [ ] 13 & above (includes SES) | |
C. GENDER: | [ ] Female | [ ] Male | |||
D. LENGTH OF SERVICE: | [ ] Under 1 year | [ ] 1-3 yrs | [ ] 4-15 yrs | [ ] 16-20 yrs | [ ] 21 & over |
E. ETHNIC GROUP: | [ ] American Indian/Alaska Native | [ ]Asian American/Pacific Islander | [ ] Black | ||
[ ] Hispanic | [ ] White (not of Hispanic origin) | [ ] Other |
THANK YOU FOR YOUR PARTICIPATION!
Footnote: 1
1 OHRM Personnel Bulletin No. 250-4, dated September 4, 1997, subject: Agency/Department Exit Interview Guidelines