DD X741 Term Employment Statement of Understanding

FOR OFFICIAL USE ONLY
OMB Number:
XXXX-XXXX
Expiration Date:
XX-XX-XXXX

DEPARTMENT OF DEFENSE
TERM EMPLOYMENT STATEMENT OF UNDERSTANDING

AGENCY DISCLOSURE NOTICE
The public reporting burden for this collection of information, 0704-XXXX, is estimated to average 5 minutes per response, including the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters
Services, at whs.mc-alex.esd.mbx.dd-dod-information-collections@mail.mil. Respondents should be aware that notwithstanding any other provision of
law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control
number.
PRIVACY ACT STATEMENT
AUTHORITY: 5 U.S.C. 301, Department Regulations; 5 U.S.C. Chapter 11, Office of Personnel Management; 5 U.S.C. Chapter 13, Special Authority;
5 U.S.C. Chapter 29, Commissions, Oaths, Records, and Reports; 5 U.S.C. Chapter 31, Authority for Employment; 5 U.S.C. Chapter 33, Examination,
Selection, and Placement; 5 U.S.C. Chapter 41, Training; 5 U.S.C. Chapter 43, Performance Appraisal; 5 U.S.C. Chapter 51, Classification; 5 U.S.C.
Chapter 53, Pay Rates and Systems; 5 U.S.C. Chapter 55, Pay Administration; 5 U.S.C. Chapter 61, Hours of Work; 5 U.S.C. Chapter 63, Leave; 5
U.S.C. Chapter 72, Antidiscrimination; Right to Petition Congress; 5 U.S.C. Chapter 75, Adverse Actions: 5 U.S.C. Chapter 83, Retirement; 5 U.S.C.
Chapter 99, Department of Defense National Security Personnel System; 5 U.S.C. 7201 Antidiscrimination Policy; minority recruitment program; 10
U.S.C. 136, Under Secretary of Defense for Personnel and Readiness; E.O. 9830, Amending the Civil Service Rules and Providing for Federal
Personnel Administration, as amended; 29 CFR part 1614.601, EEO Group Statistics; and E.O. 9397 (SSN), as amended.
PRINCIPAL PURPOSE: Form is used to acknowledge employee's term appointment position.
ROUTINE USES: In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act of 1974, these records may
specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) as follows: The DoD Blanket Routine Uses set forth at the
beginning of Office of the Secretary of Defense's compilation of systems of records notices apply to this system. The applicable systems of records
notice is DPR 34 DoD, Defense Civilian Personnel Data System, located at: http://dpcld.defense.gov/Privacy/SORNsIndex/
DODwideSORNArticleView/tabid/6797/Article/570697/dpr-34-dod.aspx
DISCLOSURE: Voluntary; however, if not furnished, acceptance for this term position may be delayed.

N E E D S

D D

6 7

SECTION I - APPLICANT/EMPLOYEE DATA

1. NAME (Last, First, MI)

3. POSITION TITLE

2. SOCIAL SECURITY NUMBER (If required)

4. PAY PLAN

5. SERIES

6. GRADE

7. ORGANIZATION

8. LOCATION

9. EFFECTIVE DATE (YYYYMMDD

10 TYPE OF EMPLOYMENT (Full time, part time) (If required)

SECTION II - APPLICANT/EMPLOYEE STATEMENT
The job you are accepting is a term position for a specified period exceeding one year and not lasting more than 6 years.
Upon expiration of this term appointment you will be separated from employment.
During your employment you will be eligible for the following:
1. Annual and sick leave;
2. Within-grade increases as appropriate;
3. Coverage under federal employees' retirement system, health benefits program, and life insurance program; and
4. Automatic enrollment in the Thrift Savings Plan (TSP).
As a term employee, you will be covered by reduction-in-force (RIF) procedures and will be placed in tenure group 3 in the event a RIF occurs during
your employment.
By signing below, I acknowledge that I understand and accept the conditions of this term employment position.

1. SIGNATURE OF EMPLOYEE

DD FORM X741, 20170907 DRAFT

2. DATE (YYYYMMDD

AEM Desiner