Receipt Acknowledgment Form

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U.S. DEPARTMENT OF JUSTICE
OFFICES, BOARDS, AND DIVISIONS
NEW EMPLOYEE ORIENTATION

I acknowledge receipt of the following Department issuances:

  1. A copy of The Executive Order on Conduct and The Standards of Conduct.
  2. Ethics Handbook.
  3. A copy of Form DOJ-373, Department of Justice Standard Schedule of Disciplinary Offenses and Penalties.
  4. If a temporary employee, a letter documenting the temporary nature and conditions of my employment.
  5. If a permanent employee, the memorandum titled, "Federal Employee Benefits."

I acknowledge receipt of information pertaining to:

  1. Harassment in the Workplace.
_______________________________
(Date)

_______________________________
(Signature)

_______________________________
(Printed Name)

revised 7/03

Updated June 25, 2015

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