Chapter 330.201a (Reduction-In-Force)
Subpart B - Establishment of the Reemployment Priority List
Register [     ] 
Update  [      ] 
Delete   [      ] 
USDA Re-Employment Priority List (RPL)
Registration Sheet
1. Name of Servicing Mission Area Personnel Office  ______________________________________
Address  ___________________________________________________________________________
Telephone _____________________                           Registrant's Agency _______________________
2.  Name of Registrant          (Last)                                   (First)                             (Middle)
                                                   ________________________________________________________
3. Address of Registrant      (Street)                          (City)              (State)                      (Zip Code)
                                                 _________________________________________________________
  Telephone Number of Registrant   (       ) _____________________
4.  Tenure Group

             (Two Years)                  (One Year)
                Career                  Career-Conditional
              (     )  1 AD                    (     )   2AD
              (     )  1 A                       (     )  2A
              (     )  1 B                       (     )  2B
5. Date of Separation

(Month)    (Date)   (Year)
______    _____   _____

6. Work Schedule

(  ) FT
(  ) PT - __hrs. per pay period
(  ) Intermittent
(  ) Seasonal
7. Available for temporary appointment                        (       ) YES                                       (      ) NO
    Available for 90 days or less appointment                (       ) YES                                       (      ) NO 
8. Series Qualification 
                                 Pay Plan                   Series       Highest Grade Eligibility        Lowest Grade Acceptable 
        Present Series    ______                    ______                       ______                                      ______

        Series 2               ______                    ______                       ______                                      ______
        Series 3               ______                    ______                       ______                                      ______
        Series 4               ______                    ______                       ______                                      ______
        Series 5               ______                    ______                       ______                                      ______
        Series 6               ______                    ______                       ______                                      ______ 

(Registration grade eligibility - no more than three grades below the position released from, except for preference eligibles with compensable service-connected disability of 30 percent or more limit is five grades.) 

(Attach blank sheet to continue series qualification for registrant) 

9. Commuting area (including designated subareas within commuting area) from which displaced.
State Abbrev.:       _____________
City:                       _____________
City Code:             _____________
10. Reasons for Registration

(      )  Reduction-In-Force
(      )  Returned from Military
(      )  Recovered compensable injury or disability

(Subareas) State:  _____________
City:                        _____________
City Code:              _____________
11. To be completed by Employing Office when the registrant is being removed from RPL

Name of Employing Office ___________________________________________________________

Reason for Removal:

(     ) (1) Appointment (Attach the Agency, type of appointment, work schedule.)
(     ) (2) Registrant's Written Request (Attach the written request.)
(     ) (3) Declination and Reasons (Attach the declinations and/or reasons.) 

12. Registrant Signature __________________________________ Date ________________________

      Appointing Officer    __________________________________ Date ________________________
 

(Registration/Update/Deletion)