Intergovernmental Personnel Act (IPA) Assignment AgreementIntergovernmental Personnel Act (Ipa) Assignment Agreement • September 17th, 2020
INSTRUCTIONS: This agreement constitutes the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the provisions of Title IV of the Intergovernmental Personnel Act (IPA) of 1970 (5 U.S.C. 3371-3376). Copies of the completed and signed agreement should be retained by each signatory. Procedural questions on completing the assignment agreement form or on other aspects relating to the IPA program should be addressed to: DeLisia Carpenter, dcarpenter@usaid.gov.
Intergovernmental Personnel Act (IPA) Assignment AgreementIntergovernmental Personnel Act (Ipa) Assignment Agreement • December 21st, 2023
PRIVACY ACT STATEMENT Authority: 5 U.S.C. 3373 and 3374; E.O. 9397, as amended by E.O. 13478, for the Social Security Number (SSN). Purpose: To collect information to manage and document the assignment of employees to or from state orlocal governments. Routine Uses: The personal information and SSN are used by the U.S. Agency for International Development (USAID) to determine eligibility for the Intergovernmental Personnel Act (IPA), and to formally document and record your temporary assignment to or from a state or local government, institution of higher education, Indian tribal government, or other eligible organization. This information may also be used as the legal basis for personal and financial transactions, to identify you when requesting information about you, e.g., from prior employers, educational institutions, or law agencies, or by State, local, or federal income taxing agencies. Disclosure: Providing personal information including your SSN is voluntary. However, failure t
Intergovernmental Personnel Act (IPA) Assignment AgreementIntergovernmental Personnel Act (Ipa) Assignment Agreement • June 7th, 2012
INSTRUCTIONS: This agreement constitutes the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the provisions of Title IV of the Intergovernmental Personnel Act (IPA) of 1970 (5U.S.C. 3371-3376). Copies of the completed and signed agreement should be retained by each signatory. Procedural questions on completing the assignment agreement form or on other aspects relating to the IPA program should be addressed to: DeLisia Carpenter, dcarpenter@usaid.gov. PART 1 – NATURE OF ASSIGNMENT AGREEMENT 1. Check all that apply: New Agreement Modification of Existing Agreement Extension of Existing Agreement PART 2 – INFORMATION ON PARTICIPATING EMPLOYEE 2. Name (Last, First, Middle) 3. Social Security Number 4. Home Address (Street, City, State, ZIP Code) 5A. Has assignee ever served on a previous IPA assignment?Yes (complete 5B) No (omit 5B) 5B. Dates of previous IPA assignment(s):From: To: (MM/YYYY) NOTE: If four continuous years are s
Intergovernmental Personnel Act (IPA) Assignment AgreementIntergovernmental Personnel Act (Ipa) Assignment Agreement • July 27th, 2023
INSTRUCTIONS: This agreement constitutes the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the provisions of Title IV of the Intergovernmental Personnel Act (IPA) of 1970 (5U.S.C. 3371-3376). Copies of the completed and signed agreement should be retained by each signatory. Procedural questions on completing the assignment agreement form or on other aspects relating to the IPA program should be addressed to the Bureau’s servicing HR Specialist. The Privacy Act Statement is found at the bottom of this form. PART 1 – NATURE OF ASSIGNMENT AGREEMENT 1. Check all that apply: New Agreement Modification of Existing Agreement Extension of Existing Agreement PART 2 – INFORMATION ON PARTICIPATING EMPLOYEE 2. Name (Last, First, Middle.) 3. Social Security Number (Last 4 digits.) 4. Home Address (Street, City, State, ZIP Code.) 5. Has assignee ever served on a previous IPA assignment? Yes (Complete 6) No (Omit 6) 6. Dates of previous
