Exhibit 1, 282 FW 3 Sample Staff Certification Form	Supersedes Exhibit 1, 282 FW 3, 02/27/06 Date:  August 22, 2011 Series: Records Management Part 282: Records Operations Originating Office: Division of Policy and Directives Management
		PDF Version

---

CERTIFICATION - STAFF

I, _________________________ on the staff of ____________________________, of the

(Name) (Office Supervisor)

_____________________________ of ________________________ do hereby certify to the Office (name of divisional, regional or field office) (bureau or office) Supervisor, that:

1. I have reviewed the instruction memorandum and attachments pertaining to the June 1, 2011 request by Congressman Jones regarding the Endangered Species Conservation Fund (ESO #            ).

2. I have undertaken a good faith search for all potentially responsive documents within the undersigned’s possession or control;

ALSO

If I was assigned to search for all potentially responsive documents created or stored by a former employee, in places known by current staff of the office to be kept by the former employee, please give the former employee’s name:   ____________________________________________.

3. CHECK THE APPROPRIATE ALTERNATIVE:

I have reason to believe that the documents identified with this certification constitute (i) all documents within the possession or control of the undersigned, and/or (ii) if certifying for a former employee, all documents created or stored, and in places known by current staff to be stored, by the above named former employee.

OR

I have reason to believe that there are no potentially responsive documents (i) within the possession or control of the undersigned, or (ii) if certifying for a former employee, all documents created or stored, and in places known by current staff to be stored, and accordingly, has not identified any documents.

4. The following is information needed to calculate costs associated with my performing the search for and production of records.

Hours/grades of individuals performing work:

Grade/Step Level

Number of Hours

Hourly Rate

Total Cost

LevNumber of

R Tal

Date: _____________   _____________________________________________________

(Signature – Print Name and Title)

                                    _________________________________________________

---

For more information on the content of this exhibit or about this Web site, contact Krista Holloway of the Division of Policy and Directives Management.

---

Directives Home

PDM Web sites: Centralized Library of Servicewide Policies | FWS Forms | PDM Services

Privacy, Disclaimer and Copyright Information | Information Quality Act

U.S. Fish and Wildlife Service Home Page | Department of the Interior  | USA.gov  | About the U.S. Fish and Wildlife Service  | Accessibility  | Privacy  | Notices  | Disclaimer  | FOIA