U.S.Fish and Wildlife Service 223 FW 5,  Exhibit 3 - Spousal Placement

REQUEST FOR SPOUSAL PLACEMENT ASSISTANCE
 

Employee's Name:                                           ___________________________________________

Social Security No.:                                         ___________________________________________

Title, Pay Plan, Series, and Grade:                   ___________________________________________

Current Duty Location/Address:                        ___________________________________________

Employment Phone Number:                            ___________________________________________

Home Address:                                               ___________________________________________

Home Phone Number:                                     ___________________________________________

Future Duty Location/Address:                         ___________________________________________

Future Employment Phone Number:                 ___________________________________________

Future Home Address (if known):                     ___________________________________________

Future Home Phone Number (if known):           ___________________________________________

Expected Date of Reporting at Future Duty Station:______________________________________

Spouse's Name:                                             ___________________________________________

Spouse's Social Security No.:                         ___________________________________________

Spouse's Present Home Address/Phone Number (if different from Employee's):
 

__________________________________________________________________________________

Specific assistance requested from the servicing personnel office:
 

__________________________________________________________________________________
 

__________________________________________________________________________________

Type of position spouse is interested in obtaining at future duty station (if Federal service, please
indicate preferred series and grade, and attach copy of most recent SF-50, if available):
 

________________________________________________________________________

CONTINUE ON REVERSE OF THIS FORM
 


For additional information regarding this Web page, contact Krista Bibb, in the Division of Policy and Directives Management, at Krista_Bibb@fws.gov 
Return to  223 FW 5

Visit the Division of PDM Directives Home Page
Visit the U.S. Fish and Wildlife Service Home Page