Example 6 XXX SSA 45 by xmOb05NH

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									                                                                                             Name
                                                                                             111-11-1111



 EXPERIENCE AND QUALIFICATIONS STATEMENT FOR POSITION VACANCY

  Announcement         Position Applied For       Vacancy Location         Grade Level (s)   Lowest Grade
    Number                                                                  Applied For       Acceptable
                                                                               GS-13               GS-13

            Name (Last, First, Middle                 Home Address (For Vacancies In SSA Field Offices)

                      XXX                                                    P.O. Box
                                                                            City, St. Zip

 Social Security Number             Current Duty Station And Address              Office Telephone Number

   111-11-1111              STREET.                                               (111) 111-1111 Ext. 111
                            City, ST. Zip
                            Presently detailed at Central Office:                 (111) 111-1111
                            Blvd
                            City, St. Zip

I. EXPERIENCE (Begin with most recent experience and work back)

 You must specify the dates at each grade level if you have had a career ladder position. Be sure to show
  all experience which is pertinent and related to your qualifications for the positions for which you are
              applying. Any details to other positions should be described in Part II-Details.

Detailed Description of Duties: (Do not attach Position Description)

         Dates Of Employment In This Position                      Exact Title Of Your
        (Specify The Dates At Each Grade Level)                         Position
 Grade      From (Mo., Day, Yr.) To (Mo., Day, Yr.) Operations Supervisor (Bilingual T2)
GS-12-2     10/17/05               Present                Average Hours Per Week         40
GS-12-1     10/17/04               10/17/05                                              40
Civil Service      Employer (Name And           Number And Kind Of       Name And Telephone Of
   Series                Address)           Employees You Supervised      Immediate Supervisor

               Social Security                           9 Direct              Name
               Administration                     Claims Representatives       111-111-1111 Ext. 111
               Street
               City, St. Zip

Detailed Description of Duties: (Do not attach Position Description)



                                              1
                                                                                                     Name
                                                                                                     111-11-1111

1) Supervision: I provide first line supervision to a fully staffed office of 70 people in a District office with a
   total TII staff of 18. I supervised the direct activities of 9 claims representatives.

2) Technical Guidance: I provide technical direction to the employees under my supervision in the
   performance of their daily tasks, which center around the administration of retirement, survivors, disability,
   health insurance, black lung, and supplemental security income programs. This includes ensuring that duties
   are performed and decisions reached are appropriate and the work processed within the SSA determined
   guidelines. I additionally provide guidance in difficult claims and post entitlement situations.

3) Organization: I plan and direct day to day activities centering on the administration of our programs. This
   includes establishing workflows and priorities and changing in accordance with variations in workload,
   emphasis, legislation, etc. I additionally consult with upper level management about major changes in
   policies and procedures.

4) Accountability/Quality Control: I regularly review the work of all employees for accuracy, completeness,
   detection of training needs, and evaluation of performance. I establish quality control techniques to
   accomplish the claims taking process in addition to a multitude of post entitlement work development. This
   includes periodic audits of desk work and/or interviews as well as incoming and outgoing mail. All of these
   tasks are to ensure fair and equal treatment of the public, including uniformed and correct application of the
   Social Security Act.

5)   Training: I regularly develop training plans and schedules for both the office at large and individual
     employees. This includes, formal sessions on the job, follow up refresher training in regards to changes in
     the law and/or its interpretation, deficiencies detected through quality control, etc. I also develop and direct
     training and orientation programs for new employees, including part time and specialty employees,
     including summer aides and Claims Representative Assistants. Training is conducted on a group basis or on
     a one on one basis depending on the circumstances. It is my responsibility to either conduct the training or
     over see it done by Technical Experts. I additionally advise employees and encourage career development in
     formal and informal settings.

6) Administration: I am responsible for writing, reading, interpreting and applying various types of
   administrative reports. I review various personnel forms for completeness and accuracy either before they
   are forwarded to appropriate authorities or after they are returned. I make certifications for processing
   within grade increases, merit promotions, for my employees. I prepare formal evaluations of employee
   performance on a regular basis. I am also responsible for taking disciplinary actions when necessary. As an
   Operations Supervisor, it is essential that I have a working knowledge of EEO issues from the context of a
   member of management to ensure that policies and procedures are properly followed.

     I exercise approval authority for several types of special payments made to members of the public through
     local action such as forced system payments for the SSI program, and critical case payments for the Title II
     programs. I serve as a disability EDCS coordinator for the local office. This function includes advising the
     office staff on procedures dealing with the implementation of the paperless disability process and the
     assistance in obtaining medical evidence for the disability claims processing. This is a very involved and
     sensitive situation with regard to public relations which involves the public, office staff as well as DDS
     supervisors. I serve as the contact person for state disability determinations and others who needed specific


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                                                                                                     Name
                                                                                                     111-11-1111

   information or action with regard to disability claims. I am also the approving official for the time and
   attendance of the employees I supervise. I serve as the alternate security officer for my office and thus have
   the responsibility of making sure that the office is secure at the end of the day, including internal and
   external locking of computer-access equipment and microfilm records. As the occasion arises, I give talks,
   speeches, and question/answer sessions to various groups in the community.

   With my bilingual/bicultural background, I assist the Spanish speaking public in conducting Social
   Security business. I also serve as an officially certified verbal and written translator. I translate
   Spanish documents for field offices in the XXX Region and provide verbal translations for the
   Service Representatives or Claims Representatives in my office. I verify the authenticity of foreign
   documents and provide written translations to Social Security staff throughout the region upon
   request.

7) Miscellaneous: I serve as a contact person for Senators, Members of Congress, and local legislators seeking
   information in general and about specific constituents. This involves resolving sensitive situations where
   delays had been experienced in processing, claims have been denied, appeals need to be solicited,
   dissatisfaction with the benefit amounts processed, and a wide variety of similar issues. I am in contact with
   staff people in both the local and regional offices of Senators and members of Congress in resolving issues
   and providing information. In addition to program knowledge, it is required that I be able to resolve public
   relations problems with sensitivity and tact in dealing with the public and with the representatives who
   expressed concerns. In summary, my duties encompass just about anything that involves making the office
   run smoothly and efficiently on a day to day basis, with the objective of the Social Security Administration
   as the ultimate goal to service to the public courteously and efficiently.

       Dates Of Employment In This Position                                    Exact Title Of Your
      (Specify The Dates At Each Grade Level)                                         Position
 Grade    From (Mo., Day, Yr.) To (Mo., Day, Yr.)               Social Insurance Sp Name
                                                                111-111-1111 Ext. 111
                                                                Specialist (Bilingual T2)
GS-11       09/25/02               10/16/04                         Average Hours Per Week          40
GS-09       09/25/01               09/24/02                                                         40
GS-07       09/24/00               09/24/01                                                         40
Civil Service      Employer (Name And                 Number And Kind Of               Name And Telephone Of
   Series                 Address)                  Employees You Supervised            Immediate Supervisor
               Social Security Admin.
                Road                                            N/A                   Name
               City, St. Zip                                                         111-111-1111 Ext. 111


Detailed Description of Duties: (Do not attach Position Description)

I conducted interviews, adjudicated initial claims and processed post entitlement actions under Titles II and
XVI and Title XVIII of the Social Security Act. I have extensive knowledge of SSA's policies and
procedures, objectives, and programs. On a daily basis, I interviewed the public and shared information


                                                3
                                                                                                   Name
                                                                                                   111-11-1111

about SSA's policies and programs. I made developmental and adjudicative decisions that conform to
SSA procedures and policies.

I reviewed claimant's documentation/provided information to ensure that they are eligible for benefits
and when eligibility is questionable, I make referrals to the proper personnel so that they can formally
verify eligibility. Part of this task involved verifying the authenticity of documentation provided.

I communicated orally with claimants and peers on a daily basis. I regularly communicated with
attorneys, bank officials, Immigration and Naturalization officials, county social services, school
administrators, and law enforcement officials to ascertain or verify information pertaining to Social
Security matters. I regularly communicated in writing through letters to businesses and members of the
public, reports of contact for my peers, and special determinations for cases determinations.

I have been a liaison for SSA within the community by acting as a link with community organizations
such as XXXX. I referred the individuals to various agencies which could provide claimants with
additional services or assistance. In various cases, I personally contacted other agencies on the behalf of
Claimants.

With my bilingual/bicultural background, I assisted the Spanish speaking public in conducting Social
Security business. I also served as an official verbal and written translator for the office. I translated
Spanish documents for Field Offices in the XXX Region and provided verbal translations for the Service
Representatives or Claims Representatives in my office. I verified the authenticity of foreign documents
and provided written translations to Social Security staff throughout the region upon request.

I negotiated with other individuals and organizations various payment or claims processing issues. I
negotiated with individuals the repayment of Title II and Title XVI overpayments, and Title II post
entitlement actions. I additionally negotiated resolutions with other agencies when issues could not be
resolved directly with the claimants.

All aspects of the work required a strong ability to analyze policies and procedural documents, to ensure
the correct action was being taken for each respective work directive.

In summary, the duties of the job involved extensive knowledge and application of the Social Security
Act, to ensure that all requirements of the law were met. I received various awards as a Claims
Representative (ROC and CASA); I had an excellent rating during the last appraisal year.




                                               4
                                                                                                  Name
                                                                                                  111-11-1111

II. DETAILS AND DEVELOPMENTAL ASSIGNMENTS

  List all details or developmental assignments you have participated in for 30 calendar days or longer
   which are relevant to the position being filled. Specify beginning and ending dates and give a brief
  description of the duties performed. If more space is needed, provide information in same format on
                                blank sheet or use Continuation Form-45A

 Date Began      Date Ended                                 Duties While On Detail
(MM/DD/YY)      (MM/DD/YY)

10/17/2005      Present in                                XXX /XXX XXXXX’ Detailed
                detail                                    Office of XXX and XXXX/XXX
                                                      XXXXXX XXXX XXXXX and XXXX Branch

                                     Title II Initial Claims SUMS count project and MI Central enhancements.

                                    o   Assist in the development of requirements and validation systems to
                                        support the SSA Unified Measurement System (SUMS) initiative.
                                    o   Review, comment and participate on proposed issuances from the TII
                                        SUMS counts project. Workload involves SUMS documentation, screen
                                        development, project validation, and screen requirements.
                                    o   Provide T2 subject matter expert support to technical leads.
                                    o   Provide supervisory experience on how the SUMS project would be
                                        perceived and used by FO management in comparison to the Legacy
                                        systems.




III. TRAINING AND SELF-DEVELOPMENT RELEVANT TO POSITION VACANCY

 Training and self-development activities may include but are not limited to OPM training courses, SSA
  training courses , Adult Education courses, training received in private industry, courses at Trade or
 Vocational Schools, Armed Forces training, and Business College courses, as well as formal education.

High School              Years          Total Credits Received                     Credit Earned Per
Graduate?     YES      Completed                                                        Course
A. Name Of College                                        Type Of
   Or University      Day    Night Sem.        Qtr.       Degree         Major Relevant           Sem.     Qtr.
     Attended                                  Hrs.       Earned         Courses/Subjects        credits   Hrs.




                                           5
                                                                                                                  Name
                                                                                                                  111-11-1111

XXX University                                                  Doctorate in
                                                                Public              *Current Student*
                                                                Administrati
XXX University                                                  on
                                                                (DPA)

                           2                28                  M.A. in             Private Sector            4
                           Years                                Management          Foundations in
                                                                * (MBA)             Management
                                                                *Graduation
                                                                May 2005            Private Sector            4
                                                                Dual Degrees        Financial
                                                                                    Management

                                                                                    Private Sector            4
                                                                                    Business Law

                                                                                    Private Sector            4
                                                                                    Human Resource
                                                                                    Management

                                                                                    Private Sector      4
                                                                                    Professional Ethics

                                                                                    Marketing for             4
                                                                                    Managers

------------------------                                                            Research Methods          4
                                                                                    and Business
                                                                                    Applications
XXX University
                           -----   ------   -----       -----   -----------------   -----------------------   -----
                                                                --                  -

                           2                60                  M.A. in             Communication &           4
                           Years                                Public              Conflict
                                                                Administrati
                                                                on                  Critical Issues in
                                                                  (MAPA)            Public                    4
                                                                *degree             Administration
                                                                requirements
                                                                completion          Managing for              4
                                                                May 2004 –          technology
                                                                Graduated
                                                                with dual           Financial



                                                    6
                                          Name
                                          111-11-1111

    Masters      Management of        4
    degrees in   the Private Sector
    May 2005.
                 Foundations in       4
                 Public
                 Administration

                 Research Methods     4
                 in
                 Public
                 Administration

                 Human Resource       4
                 Management

                 Foundations in       4
                 Management and
                 Leadership

                 Regulation           4
                 Management

                 Public Sector       4
                 Professional Ethics

                 Working With an    4
                 Enlarging
                 European Union:
                 Comparative
                 Perspectives on
                 Negotiation and
                 Dispute Resolution
                 Processes for
                 International
                 Lawyers and
                 Managers.

                 Public Policy        4
                 Analysis

                 Organizational       4
                 Theory &
                 Behavior

                 Public Fiscal        4


7
                                                                                                    Name
                                                                                                    111-11-1111

-------------------------                                             Management
XXX State
University                                                            Public Sector             4
                                                                      Human Resource
                                                                      Management II
                            ------   ------       -----------------   -----------------------
                            4 Yrs.   132          B.A.                Psychology/
                                                  Psychology          Advanced                  32
                                                                      Psychology
                                                                      Courses

                                                                      Sociology                 12

                                                                      English/writing           22

                                                                      Technical Writing         4

                                                                      Mathematics               8

                                                                      Computer
                                                                      Sciences                  12
                                                                      (programming and
                                                                      web development
                                                                      intermediate level)

                                                                      Spanish                   20

                                                                      French                    8

                                                                      Biology                   4

                                                                      Physics                   4

                                                                      Research Methods          8

                                                                      Humanities                8

                                                                      Multicultural             8
                                                                      Studies

                                                                      Oral                      4
                                                                      Communications

                                                                      Political Science         4



                                              8
                                                                                         Name
                                                                                         111-11-1111

  B. School Or        Dates            Title of Course or Subject        Total    Full Or    Certificate
Training Facility    Attended                                            No. Of    Part      Received?
                                                                         Hours     Time
XXX University      01/09/03-    Certificate in Human Resources          48       Full       YES
Graduate School     01/30/03     (seminar series)

                    04/07/03     Operating Styles at work (seminar)      4        Full       N/A

                    05/16/03     Tools for the New Manager (seminar)     8        Full       N/A

                    09/19/03     Diversity in the Workplace (seminar)    2        N/A        N/A

                    11/07/03     The Changing Face of Public Service     2        N/A        N/A
                                 In the .com, .gov, .org, and .edu Era
                                 (seminar)
SSA Training

SSA
                    09/24/00     T II Social Insurance Specialist        520      N/A        N/A
                    12/10/00
SSA
                    2001         Representative Payee System             8        N/A        N/A
SSA
                    09/18/01     Spanish Claims Representative           24       N/A        N/A
                    09/20/01     Bilingual Training
SSA
                    08/2003      SSA Recruiter Training                  4        N/A        N/A
SSA
                    01/23/03     SSA Speaker's Bureau Training           6        N/A        N/A
SSA
                    03/25/2004   Project Management: Leadership and      40       Full       YES
                                 language
SSA
                    05/29/05     Nuts and Bolts Training (supervisory    48       Full       N/A
                                 training O.S.)
SSA
                    11/05/05     WinRunner Training (Central Office)     8        Full       YES

SSA
                    10/19/05     Caliber RM 2005 Training (Central       24       N/A        N/A
                                 Office).
SSA
                    12/05/05     Data Warehousing Concepts (TDWI         8        Full       YES
                                 Central Office)
SSA


                                          9
                                                                                                         Name
                                                                                                         111-11-1111

                    05/15/06        Test Director Essentials 8.0                    8          Full          YES
University of
XXX Institute of    Summer          Advanced Website Development,                   40         Full          N/A
Technology          1992            Computer Hardware Maintenance,
                                    Basic (type) Programming
State University

                    1999            Microsoft Systems Engineer training             24         Full          YES
                                    (MCSE)




IV. PERTINENT OUTSIDE ACTIVITIES (Refer to Factors and Weights for Position Vacancy)

  Outside Activities generally fall in the category of pertinent civic, welfare, service and organizational
   activity performed either with or without compensation. List all outside activities which you have
 participated in, and which you believe are relevant to the position for which you are applying, as mere
 membership alone will not be given credit. Please be specific as to your actual degree of participation.
               Include the amount of time (weekly, monthly, etc.) spent on these activities.

 Date Began   Date Ended       Organization           Position          Briefly Describe Your               Amount Of
 (mm/dd/yy)   (mm/dd/yy)                                Held                Participation                   Time Spent
03/10/06      Present          Adult English        English         Provide English teaching sessions       3-5 hours
                               Tutoring             Teacher/Tutor   to groups of adults with limited        per week.
                               Academy                              English proficiency, including
                               XXXX, XX                             workplace English needs.
                                                                    Tutoring also includes, study
                                                                    assistance for citizenship or GED
                                                                    examinations, as well as workplace
                                                                    English tutoring.


09/01/01      10/15/2005       Chicago              Vice-Chair    Responsible for working with              Up to 20
              (elected 2       Region               XX State Rep. other SSA employees (CR-                  hours per
              consecutive 2    Hispanic                           HAC members) in XX STATE.                 week when
              year terms)      Action                             I advise members of CR-HAC                planning
                               Committee                          events, plan CR-HAC                       community
                               (CR-HAC)                           sponsored community outreach              outreach
                                                                  projects, welcome new                     projects.
                                                                  members, and provide support              On average
                                                                  and advice on work related                1-3 hours
                                                                  concerns.                                 per week.




                                               10
                                                                                              Name
                                                                                              111-11-1111




06/15/95       2002           Habitat for        Volunteer     Volunteer with Habitat for        Up to 10
                              Humanity                         Humanity, every summer since      hours per
                                                               1995. As a volunteer, I have      week.
                                                               developed valuable
                                                               communication skills.
                                                               Volunteering has also
                                                               strengthened my commitment
                                                               and connection towards the
                                                               community.




09/01/01       Present        Community          Coordinator   Coordinator and leader of         Up to 20
                              Outreach           XX CRHAC      various community outreach        hours per
                              Leader                           projects with the objective to    week when
                                                               provide the community with a      planning
                                                               positive perception of the        Projects.
                                                               Social Security Administration.

V. AWARDS-LIST ALL JOB-RELATED AWARDS

  Type Of Award, Special      Month And Year Grade Level                  Brief Summary Of Award
   Achievement, HQI Or           Of Award      At Time
           Other                              Of Award
On the Spot Award (OSA)       03/30/01       GS-7                 Award issued as a tangible way of
                                                                  acknowledging contributions to office
                                                                  accomplishments.


Commendable Act or Service    05/03/02               GS-09        Significant contributions to agency's
Award (CASA)                                                      mission. Empathy, patience and courtesy
                                                                  to the public and co-workers, which
                                                                  significantly contributed to office
                                                                  accomplishments.

Outstanding Performance       10/12/02               GS-11        In recognition of outstanding performance
Award (OPA)                                                       as a coordinator/canvasser to the SSA
                                                                  Year 2002 Savings Bond Campaign.

Recognition of Contribution   04/15/03               GS-11        Consistent superior performance in the
Performance Award (ROC)                                           areas of leadership, dependability and for


                                            11
                                                                                                 Name
                                                                                                 111-11-1111

                                                                     acknowledgment of significant
                                                                     contributions to agency's mission and
                                                                     office accomplishments. A recognition
                                                                     and appreciation from the public and peers
                                                                     for high levels of dedication and
                                                                     professionalism.

Time Off Award (TOA)             04/15/03            GS-11           In recognition of patience and flexibility
                                                                     shown in providing interpretive services.

On the Spot Award (OSA)          04/15/03            GS-11           In recognition of patience and flexibility in
                                                                     providing outstanding service to
                                                                     customers.

Recognition of Contribution      04/10/04            GS-11           Consistency in providing high level of
Performance Award (ROC)                                              contribution to the agency mission,
                                                                     dependability, and technical ability.

On the Spot Award (OSA)          04/10/04            GS-11           Providing outstanding service to the
                                                                     public.

On-the Spot Award (OSA)          08/06/04            GS-11           Significant contribution in assisting
                                                                     backlogged unit.

Commendable Act or Service       04/16/05            GS-12           In recognition of significantly improving
Award (CASA)                                                         work units performance and in providing
                                                                     outstanding customer service.
VI. HIGHEST GRADE HELD

 Enter Highest Grade Held In Federal Service         GS-12


VII. SKILLS

Typing WPM        50                Shorthand WPM           N/A              Card Punching CPM          N/A
   Other:                 Computer hardware training (can replace/install any internal or external hardware).
                          Computer programming experience (HTML, JavaScript, XML & ASP). Current web
                           master for websites.
                          Proficiency in multiple software applications, including; Microsoft Excel, Microsoft
                           PowerPoint, Microsoft Word, Microsoft Access, Microsoft FrontPage, Corel
                           WordPerfect, Adobe Acrobat, etc.




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                                                                                            Name
                                                                                            111-11-1111




              Ability To Speak Or Write In A Language Other Than English Language
  Language:     Spanish
            Speech                       Comprehension                     Translation
    Fluent          Passable          Good            Fair            Good             Fair
Spanish                          Spanish                         Spanish


IX. SSA AND OPM TESTS TAKEN

    SSA Test Title          Score         Date           OPM Test Title             Score          Date



VIII. PANEL INTERVIEW RESULTS (For meet and deal positions)

Panel Interview Taken?              Rating                 Date                   Attach Copy of Results

 I certify that the statements made by me on this form are true, complete, and correct to the best of my
    knowledge and belief and are made in good faith. Falsification of any information on this form is
              punishable by fine or imprisonment under U.S. CODE TITLE 18, SEC. 1001.


Signature:           /s/                                           Date:          06/19/06




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