INTERGOVERNMENTAL PERSONNEL ACT AGREEMENTPersonnel Act Agreement • October 12th, 2016
INSTRUCTIONS This agreement constitutes the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the provisions of the Intergovernmental Personnel Act of 1970, 5 CFR 334 and 3 FAM 2416.The term, State/Local Government or "Other" Organization, when appearing on this form, also refers to an institution of higher education, an Indian tribal government, and any other eligible organization.A copy of the completed and signed agreement should be retained by each signatory. The final agreement is filed on the left-hand side of the employee's Official Personnel Folder (OPF).Use the continuation sheet at page 5 when additional space is needed to respond to the question(s). PART 1: NATURE OF THE ASSIGNMENT Initial assignments, modifications, and all extensions require the approval of the Under Secretary for Management (M) or Designee. 1. New Agreement Modification Extension PART 2: INFORMATION ON PARTICIPATING EMPLOYEE 2. Name (Last, First
