223 FW 5, Exhibit
3 - Spousal Placement
Employee's Name: ___________________________________________
Social Security No.: ___________________________________________
Title, Pay Plan, Series, and Grade: ___________________________________________
Current Duty Location/Address: ___________________________________________
Employment Phone Number: ___________________________________________
Home Address: ___________________________________________
Home Phone Number: ___________________________________________
Future Duty Location/Address: ___________________________________________
Future Employment Phone Number: ___________________________________________
Future Home Address (if known): ___________________________________________
Future Home Phone Number (if known): ___________________________________________
Expected Date of Reporting at Future Duty Station:______________________________________
Spouse's Name: ___________________________________________
Spouse's Social Security No.: ___________________________________________
Spouse's
Present Home Address/Phone Number (if different from Employee's):
__________________________________________________________________________________
Specific
assistance requested from the servicing personnel office:
__________________________________________________________________________________
__________________________________________________________________________________
Type
of position spouse is interested in obtaining at future duty station (if
Federal service, please
indicate
preferred series and grade, and attach copy of most recent SF-50, if available):
________________________________________________________________________