Form Gsa 3694 - Request For Waiver Of Dual Compensation (Salary Offset)
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2REQUEST FOR WAIVER OF DUAL COMPENSATION (SALARY OFFSET)
OTHER UNUSUAL CIRCUMSTANCES
requests a dual compensation reduction (salary offset) waiver for
Name of Requestor
. This waiver will allow
{name of reemployed annuitant}
to reemploy
{name of requesting organization}
for work needed as a result of
{name of reemployed annuitant}
Describe the unusual
circumstance for
which the individual's
services are needed.
The
will appoint
{name of requesting organization}
on a
{indicate the appointing authority that will be used to reemploy the annuitant}
appointment to
{title}
{series}
{grade}
.
The
is requesting this waiver under the criteria in
{name of requesting organization}
5 CFR 553.201 (f) - "Requests based on other unusual circumstances." The criteria for approving a waiver for
are met and supported by the following information:
(1) The unusual circumstance. Describe the unusual circumstance, when it first occurred, and the length of time
expected for the unusual circumstance to last.
(2) Relationship between the waiver request and the agency's mission. Describe how the waiver request directly
supports the agency's mission.
GENERAL SERVICES ADMINISTRATION
GSA 3694 4/2009
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Parent category: Financial