Form OF 69, Assignment Agreement, is the U.S. Office of Personnel Management (OPM) form that serves as the written record of a temporary assignment arranged under Title IV of the Intergovernmental Personnel Act of 1970 (IPA). It is completed for a federal employee, or a state or local employee, who moves between a federal agency and a state or local government. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form itself is published by the U.S. General Services Administration (GSA) at gsa.gov.
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What is OF 69?
Form OF 69, Assignment Agreement, is the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the Intergovernmental Personnel Act of 1970, issued under the authority of the U.S. Office of Personnel Management (OPM).
The form cites Title IV of the Act (5 U.S.C. 3371-3376) and FPM Chapter 334. Its Privacy Act statement adds that Sections 3373 and 3374 of Title 5, U.S. Code, authorize the collection of the information, which is used mainly to document and record the temporary assignment to or from a State or local government, institution of higher education, Indian tribal government or other eligible organization. On the form, the term "State or local government" also covers those organizations.
The agreement is organized in 15 parts:
- nature of the agreement (new agreement, modification or extension), the participating employee and the parties;
- position data for the current and the assignment position, and the type and period of the assignment;
- the reason for the assignment, the position description, pay and leave, fiscal obligations, conflict-of-interest and conduct notices, optional benefit coverage, and travel and transportation;
- the rules the employee acknowledges, and the certifications signed by the employee and the approving officials.
The form is not a stand-alone application to a program: it documents the arrangement the two employers and the employee have already agreed to.
Who needs to file OF 69?
The parties to a temporary assignment arranged under the Intergovernmental Personnel Act of 1970 complete this agreement: the participating employee, the Federal agency and the State or local government agency. State or local government here includes an institution of higher education, an Indian tribal government and any other eligible organization.
How the groups use it:
- Federal employees assigned to a State or local government, shown on the form as on detail from, or on leave from, a Federal agency.
- State or local employees assigned to a Federal agency, shown as on detail to, or on appointment in, a Federal agency.
- Authorizing officers of the State or local government agency and of the Federal agency, who sign Part 15 with their typed name and title.
Some entries apply to one group only. Part 13, box E, the commitment to serve in the Civil Service for a period equal to the assignment, is marked "For Federal Employees only". Line 31 concerns State or local agency benefits for a State or local employee assigned to a Federal agency. The form does not describe representatives who may sign for the employee.
When to file OF 69
Within 30 days of the effective date of the assignment, two copies of the form must be sent to OPM. The assignment dates themselves are entered on line 20, Period of Assignment, with the month, day and year of the start and end.
Part 1 lets you mark the agreement as a New Agreement, a Modification or an Extension, so the same form is used when an existing arrangement changes. The form sets no other deadline and prints no processing time. Each signatory should keep a copy of the completed, signed agreement.
How to fill out OF 69
Mark the nature of the agreement
In Part 1, line 1, check New Agreement, Modification or Extension.
Enter the employee's information
In Part 2, enter the name (Last, First, Middle) on line 2, the Social Security Number on line 3 and the home address on line 4. On line 5-A answer YES or NO to a previous mobility assignment and, if YES, give each assignment's From and To dates (month and year) on line 5-B.
Identify the parties
In Part 3, name the office, bureau or organizational unit of the Federal agency on line 6 and the governmental agency on line 7. On line 8 answer YES or NO to a faculty fellows program and, if YES, give its name.
Describe the current position
In Part 4-A, enter the employment office name and address (line 9), position title (line 10), office telephone number with area code (line 11) and immediate supervisor's name and title (line 12).
Enter the type of current appointment
In Part 4-B, Federal employees complete line 13: check Career, Competitive or Other (specify) and give the grade level. State and local employees complete line 14: the annual salary and the original date employed by the State or local government (month, day, year).
Describe the assignment position
In Part 4-C, enter the employment office name and address (line 15), the assignee's position title (line 16), the office telephone number (line 17) and the immediate supervisor's name and title (line 18).
Select the type and period
In Part 5, line 19, check the type of assignment (on detail from or to a Federal agency, on leave from a Federal agency, or on appointment in a Federal agency) and whether it is Full Time, Part Time or Intermittent. On line 20 enter the From and To dates (month, day, year).
Explain the reason and the duties
In Part 6, line 21, give the reasons for the assignment, how the work benefits the participating governments and how the employee will be used at the end. In Part 7, line 22, list the major duties and responsibilities.
Complete pay and leave terms
In Part 8, enter the rate of basic pay (line 23), any special pay conditions that could increase compensation (line 24) and the annual and sick leave benefits with the procedures for reporting, requesting and recording leave (line 25).
State the fiscal obligations
In Part 9, identify the office to which invoices and time and attendance records go. Enter the Federal agency obligations on line 26, including the rationale for cost-sharing when it pays over 50 percent of a Federal employee's salary beyond 6 months, and the State or local agency obligations on line 27.
Cover conflicts, options and travel
Parts 10 and 11: lines 28 and 29 are statements on conflict-of-interest and conduct notices. On line 30 mark Covered or N/A for group life insurance, retirement and health benefits; use lines 31 and 32 for State or local and other benefits. In Part 12, line 33, say who pays travel and transportation and which expenses are included.
Check the Part 13 boxes
In Part 13, line 34, check each statement that applies, boxes A through E. Box E applies to Federal employees only.
Complete the certifications
In Part 14, enter the location of assignment (line 35), the From and To dates (line 36), and the employee's signature and date (lines 37-38). In Part 15, the State or local and Federal authorizing officers sign (lines 39 and 40), date (lines 41 and 42) and give a typed name and title (lines 43 and 44).
Review, download and send
Check every line against the assignment terms, then download or print the completed PDF from FillingPDF. Make the copies described under How to submit.
How to submit OF 69
The form gives one destination: two copies are sent to OPM within 30 days of the effective date of the assignment.
- Where to send the two copies: U.S. Office of Personnel Management, Personnel Mobility Program, Staffing Operations Division/CEG, 1900 E street, NW, Washington, D.C. 20415.
- Copies for the signatories: copies of the completed and signed agreement should be retained by each signatory.
- Questions: procedural questions about completing the agreement, or about the mobility program, go to the mobility program coordinators in each Federal agency or to the staff of the Personnel Mobility Program at OPM.
The form prints no portal, fax number, telephone number or private-delivery address. Before sending, check that the employee has signed Part 14 and that both authorizing officers have signed Part 15.
FillingPDF lets you fill out and download the PDF; submission follows the channel above.
Common mistakes to avoid
- Sending the agreement to OPM later than 30 days after the effective date of the assignment.
- Sending one copy to OPM when the form asks for two copies.
- Not keeping a copy of the completed, signed agreement for each signatory.
- Leaving a coverage line in Part 11 blank instead of marking Covered or N/A for life insurance, retirement system or health benefits.
- Leaving out the rationale for the cost-sharing decision on line 26 when the Federal agency pays more than 50 percent of a Federal employee's salary beyond a 6-month period.
- Answering line 21 without saying how the work benefits the participating governments or how the employee will be used when the assignment ends.
- Marking Part 13, box E, for an employee who is not a Federal employee; the form limits it to Federal employees.
- Submitting the form without the employee's signature in Part 14 or without both authorizing officers' signatures in Part 15.
Frequently asked questions
What is Form OF 69, Assignment Agreement?
Form OF 69 is the written record of the obligations and responsibilities of the parties to a temporary assignment arranged under the Intergovernmental Personnel Act of 1970. It documents an assignment between a Federal agency and a State or local government, institution of higher education, Indian tribal government or other eligible organization.
Where do I send the OF 69 Assignment Agreement?
Send two copies to the U.S. Office of Personnel Management, Personnel Mobility Program, Staffing Operations Division/CEG, 1900 E street, NW, Washington, D.C. 20415. The form prints no other channel, such as an online portal or fax number.
What is the deadline for submitting Form OF 69?
Two copies must reach OPM within 30 days of the effective date of the assignment. The form prints that period in its instructions and no other deadline. Each signatory should also keep a copy of the completed, signed agreement.
Who signs the Assignment Agreement?
The assigned employee signs Part 14, line 37. In Part 15, an authorizing officer of the State or local government agency signs on line 39 and an authorizing officer of the Federal agency signs on line 40, each with a date, typed name and title.
Can I use OF 69 to change or extend an existing assignment?
Yes. Part 1, line 1, offers three boxes: New Agreement, Modification and Extension. Check the one that matches the purpose of the agreement you are completing.
Do I have to give my Social Security Number on Form OF 69?
The form asks for it on line 3. Its Privacy Act statement says that giving the number or any other requested data is voluntary, but that failure to provide requested information may make you ineligible to take part in the Intergovernmental Assignment Program.
Can I fill out OF 69 online and submit it through FillingPDF?
You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not submit the form to OPM; you send the two copies to OPM yourself as described on the form.
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