Office, Board, Division, Bureau:
Name of Appointee:
Title and Organizational Location of Appointee:
Evaluation of Qualifications Based on Completed Federal Application or Resume:
Statement of Duties and Justification of Need for the Position as an Expert or Consultant:
Daily or Hourly Rate of Pay and Justification of Rate:
Tour of Duty:
| Intermittent____ | Estimated Number of Days to be Worked_____ |
| Regular Tour of Duty ___ | Description of Tour__________________ |
Effective Date of Appointment:
Expiration Date:
Reappointment Date:
Certificate of Understanding: A Certificate has been obtained from the appointee.
YES ___ NO ___
Expert/Consultant Certificate: A Certificate has been completed.
YES___ NO___
Additional Comments:
Last Updated February 2, 2000
usdoj/jmd/ps/jpc