Fillable Printable OPM Form 1396
Fillable Printable OPM Form 1396
OPM Form 1396
_
__________________________________________________________________________________
Request to Establish or Discontinue
a Personnel Office Identifier, or to Change POI Information
TO: U.S. OFFICE OF PERSONNEL FROM:
MANAGEMENT
PERSONNEL SYSTEMS GROUP
1900 E STREET NW
WASHINGTON, DC 20415-6000
INSTRUCTIONS
1. To ESTABLISH a POI, complete all items in the "TO" Section only, except for item #2
2. To DISCONTINUE a POI, complete the "FROM" Section only.
3. To CHANGE a POI, complete both "FROM & TO" Sections.
4. ACTION CODES ARE: E=Establish, D=Discontinue, C= Change
FROM:
1. Agency/Subelement Code 2. POI 3. Action Code 4. Effective Date (Month/Year)
5. Agency Name (Name of Department or Independent Agency)
6. Agency Mailing Address
7. City 8. State 9. Zip Code (9 digits
10. Duty Station Code of the Personnel Office
11. ASP (OPM Use)
12. Name of the Personnel Officer or Head of Office 13. Phone Number (with whatever applies International/
Country Codes, Area Code, Number, or Extension)
14. Name of the Contact For Employee Surveys (if different than item 12) 15. Phone Number (with whatever applies international/
Country Codes, Area Code, Number, or Extension)
TO:
1. Agency/Subelement Code
2. POI 3. Action Code 4. Effective Date (Month/Year)
5. Agency Name (Name of Department or Independent Agency)
6. Agency Mailing Address
7. City
8. State 9. Zip Code (9 digits
)
10. Duty Station Code of the Personnel Office 11. ASP (OPM Use)
12. Name of the Personnel Officer or Head of Office 13. Phone Number (with whatever applies International/
Country Codes, Area Code, Number, or Extension)
14. Name of the Contact For Employee Surveys (if different than item 12)
15. Phone Number (with whatever applies international/
Country Codes, Area Code, Number, or Extension)
16. Signature of the Person Submitting This Form 17. Typed Name and Title of Submitter 18. Date Signed
U.S. Office of Personnel Management OPM Form 1396
AUTHORIZED FOR LOCAL REPRODUCTION (Rev 8/2012)
