Classification

INTELLIGENCECOMMUNITYJOINTDUTYCLAIMFORM

The purpose of this optional formistoclaimjoint duty creditas describedinandauthorizedby IntelligenceCommunityDirective Number660(IntelligenceCommunityCivilian Joint DutyProgram)and Intelligence CommunityPolicyGuidance 660.1(IntelligenceCommunityCivilianJointDuty ProgramImplementationGuidance). This form does not preclude other means, to include automated processes, established by employing IC elements for granting joint duty credit to its employees who have met the applicable service requirements for a joint duty qualifying experience. Forms may be submitted to the individual’s current employing IC element joint duty program office, using the POC information under the “Contacts” tab on the IC Joint Duty website.

SECTION A:CURRENTEMPLOYEEINFORMATION

1.Official Name:

2.PayGrade orEquivalent:

3.PositionTitle:

4.EmployingIC Element:

5.Organization/Office/Unit:

6.Unclass CommercialPhone #:

7.Total # of pagessubmitted:

Returnadjudicateddecisiontomeat:

SECTION B:JOINT DUTYCLAIMINFORMATION: Select appropriate block(s) to indicatequalifying experience.Youmustuseoneformper claim.

Joint Duty Rotation to another IC element of at least 365 calendar days

Combat Zone Civilian Deployment of at least 179 calendar days

Other (e.g. qualifying rotation to non-IC element; private sector, academic, military or other qualifying work prior to joining your current IC element as a civilian employee;
1. Position Grade or Equivalent:

PositionTitle:

GainingElement:

Assignment Dates:

TotalAssignmentLengthinMonths:

Attachdocumentation that demonstrates the followingfor the claim: Nomore than one page brieflydescribingthe jointdutyworkperformed Evidence of assignment length (e.g. MoA/MoU,SF-50, etc.)

Evidencethattheassignmentwasatthe positionlevel ofGS/GG-11or equivalent or above (e.g. MoA/MoU, SF-50, etc.)Evidence ofnot less than asuccessful performance rating(appraisal,letterof commendation,etc.)

Other supportingdocumentation(optional; e.g. travelorders,DD-214,positiondescription, etc.)

Have you previouslyfiled a claimfor joint duty creditbased on theassignment(s)listedherein?YESNO

If YES,towhich ICElementdidyou submittheclaimand whendid yousubmitit?

I affirmthat all statementson thisform, andall attachmentsto it, are trueand correct tothe best ofmy belief.

Signature(signinink)Date

TheNationalSecurityActof1947,asamended(50USC§403),authorizesthecollectionofthisinformationinfurtheranceof theICCivilianJointDutyProgram.Providingtheinformationrequested,includingtheSSN,isvoluntary,howeverclaimslackingtheSSNoruniqueidentifiermaynotbeprocessed.Yourclaimandtheadjudicator’sdecisionmay besharedwiththegainingoremployingICelementsandwiththeOfficeoftheDirectorofNationalIntelligenceforpurposesofworkforceadministration,andwithcontractorsengagedtoconductstatisticalanalyses.YourICelement’sprivacyactroutineusesmayalsoapplytothisinformation.ToensureconsistencyinICelementadjudications,youradjudicatedclaimalsomaybesharedwithacommitteeofhumanresourceofficersfromacrosstheIC.

Below to be completed by adjudicatorat individual’s current employing IC element joint duty program office

Approved

Denied

Date Received:

Printed name and title ofadjudicator

AdditionalAdjudicatorComments:

Signature ofadjudicatorDate

Classification

INTELLIGENCECOMMUNITYJOINTDUTYCLAIMFORMINSTRUCTIONS

(Note:Yourcurrent employing ICelement joint duty program office may haveadditionalinstructions. IfyouhaveanyquestionscontactyourICelement'sjoint duty program office, which is listed under the “Contacts” tab on the IC Joint Duty website)

Classification–Indicate classification of all pages.

SECTIONA:EmployeeCurrentInformation-Completethissectionwithcurrentinformation.

1.OfficialName-Last,first,middleinitial,suffix.

2.PayGradeorequivalent

3.PositionTitle-Writecurrentpositiontitle.

4.Current EmployingICelement

5.Organization/Office/Unit-Currentofficeinformation/location.

6.Phonenumber-(XXX)XXX-XXXX-Currentunclassifiedcommercialphonenumber.

7.Total#ofpagessubmitted-Thisincludestheclaimformandallattacheddocuments.

Returnadjudicateddecisiontomeat-Tellushowtogettheadjudicateddecisionbacktoyou.

SECTIONB:JointDutyClaimInformation-Selectappropriateblock(s)toclaimjointdutyexperience.Generally,foranassignmenttocounttowardsjointdutycredititmusthavebeencompletedonorafter11September2001for GS-13 and above, or after 30 January 2013 for GS-11 and GS-12.

CREDITFORJOINTDUTY:

-MustbeapositionofGS-11orequivalentorabove.

-Assignment(s)mustbeatleast365 calendar days(179daysifdeployed as a civilian to acombatzone).

-Musthaveat least a successful performancerating.

Multipleassignmentsofnolessthan90consecutivedaysmaybecumulativelyappliedtosatisfythe365 calendar dayrequirement(179daysifinacombatzone),solongasthatminimumrequirementismetwithina36-monthperiod.

Experiences,suchas full time degree earning study at the National Intelligence University, prior qualifying militaryexperience,workintheprivatesectororpublicsector,and/oracademiamaycountforjointdutycreditiftheclaimedworkmeetsthejointduty qualifying experience definition and criteriastipulatedinICPolicyGuidance660.1. In addition, certain internal IC element positions can provide joint duty qualifying experience. For more information, please contact your employing element joint duty program manager.

BriefDescription-Brieflydescribethejointdutyworkperformedononepage.

DocumentationRequirements-Providedocumentationasindicatedontheclaimform.Onedocument,suchasaperformanceappraisal,maysatisfyoneormoreoftheevidentiaryrequirements.Ifcompletedocumentationisnotprovided,yourclaimmaybedenied.Ifyouacquirenewandmaterialevidenceinsupportofyourclaim,youmaysubmitittoyourjointdutyorhumanresourcepointofcontactaccordingtotheinternalpoliciesandproceduresofyour employingICelement.