I, Employee Name, voluntarily request the conversion from my current competitive service position under Title 5 U.S.C., to an excepted service position under Title 42, U.S.C., Section 209(f), within in the Department Name, Clinical Center, National Institutes of Health.

Specifically, I understand that I am converting from my current position of Position Title, series, grade, step, with an annual salary of $Salary to the position of Position Title, series, pay band, with an annual salary of $T42 Salary.

I understand that the Title 42 appointment does not represent a permanent position within the federal service. However, there is no time limitation associated with this appointment. I further understand that if I have not completed my probationary period prior to conversion, I am required to complete any remaining service time to satisfy this requirement.

I understand that as a Title 42 employee, I will not be assigned to a classified position description; however, I will be provided with a Statement of Duties for the position I am accepting. In addition, my assigned supervisor will discuss the position’s competencies with me as well as his/her expectations as they relate to performance. I understand that I will be placed on a performance and competency assessment plan appropriate for my position. I understand that my performance will be reviewed mid way through the rating cycle and at the end of the rating cycle.

I understand that pay increases other than annual cost of living adjustments (COLAs), will be determined by my performance, progression in competencies and responsibilities, and availability of departmental funds. I further understand that the Title 42 appointment may be terminated for cause (e.g., poor performance or conduct), following the procedures outlined in the Title 42 Clinical Research Support policy at http://ohrm.cc.nih.gov/employ/title42/
t42proposal.htm.

I understand that as a Title 42 employee, I will retain any reinstatement eligibility to which I am currently entitled. If I wish to return to the competitive service under Title 5 in the future, I understand that I must apply, compete and be selected for the position.

I understand that as a Title 42 employee, I will not be entitled to many of the appeal rights that are afforded to employees under Title 5. I further understand that there are no appeal rights to the Merit Systems Protection Board (MSPB) associated with this appointment. However, I will have access to NIH Equal Employment Opportunity (EEO) and the NIH Alternative Dispute Resolution (ADR) procedures.

I understand that as a Title 42 employee I will continue to have available to me (in the same manner as for my current position) the following: Federal retirement, Social Security, Thrift Saving Plan (TSP), Medicare, Federal Employees Group Life Insurance (FEGLI), Federal Employees Health Benefits Program (FEHBP), Annual and Sick Leave, Training, Standards of Conduct, Medical Qualifications, Federal Employment Compensation Act (FECA) (worker’s compensation), Restrictions on Political Activity, Outside Work Activities, Conflict of Interest, and Tort Claims Act.

I hereby acknowledge and accept the terms and conditions outlined above:

Employee Name	Date

Title 42 Excepted Service – Clinical Research Support

Voluntary Conversion Statement to

Indefinite Appointment

CCT42-4-10/16/01

Title 42 Excepted Service

TReed

2001-10-03

chiukk

OHRM