Fillable Printable OPM Form 1558
Fillable Printable OPM Form 1558
OPM Form 1558
ANNUAL SENIOR EXECUTIVE SERVICE RATINGS AND PAY-FOR-PERFORMANCE SUMMARY DATA REPORT
Part A - General Information
1. Department, Agency, Component(s)
2. Date (enter date as mm/dd/yyyy)
3. Point of Contact Name (First, Last)
4. Phone Number
5. Point of Contact Email
6. Performance Appraisal System Certification
7. Performance Appraisal System Certification Date (mm/dd/yyyy)
Provisional
Full N/A
8a. Performance Cycle Beginning Date (enter date as mm/dd/yyyy) 8b. Performance Cycle Ending Date (enter date as mm/dd/yyyy)
9. Summary Rating Pattern
10. Total SES Members
(enter D, F, G or H)
11. Total SES Members Eligible to be Rated
12. Total SES Members Not Rated
Career
Non-career
Limited
Non-career
Career Limited
Part B - Data
2. Appt.
3. New
Compensation
Awards Amount
4. Rating
Type
Appt.
9. Performance Award Pool Amount $_____________________ %_______
Place
5. Rate of Basic
6. Rate of Basic
7. Pay Amount to
8. Pct. of
1. Number
of
Members
C, N,
or L
"X" for
New
Appt.
5, 4,
3, 2,
1, or N
Pay Prior to
Performance-Based
Pay Adjustment
Pay After
Performance-Based
Pay Adjustment
Maintain Relative
Position
(if any)
Performance
Based Pay
Adjustment
10.
Performance
Amount
11.
Performance
Pct.
12.
Cash
Amount
13.
Cash
Pct.
14. Distinguished
Presidential Rank
Amount
15. Meritorious
Presidential Rank
Amount
16. Aggregate
Compensation
Amount
OPM 1558
Rev.June 2005
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Part B - Data
1. Number
of
Members
2. Appt.
Type
3. New
Appt.
4. Rating
Compensation
Awards Amount
16. Aggregate
Compensation
Amount
C, N,
or L
Place
"X" for
New
Appt.
5, 4,
3, 2,
1, or N
5. Rate of Basic
Pay Prior to
Performance-Based
Pay Adjustment
6. Rate of Basic
Pay After
Performance-Based
Pay Adjustment
7. Pay Amount to
Maintain Relative
Position
(if any)
8. Pct. of
Performance
Based Pay
Adjustment
9. Performance Award Pool Amount $_____________________ %_______
10.
Performance
Amount
11.
Performance
Pct.
12.
Cash
Amount
13.
Cash
Pct.
14. Distinguished
Presidential Rank
Amount
15. Meritorious
Presidential Rank
Amount
OPM 1558
Rev. June 2005
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INSTRUCTIONS FOR THE ANNUAL SENIOR EXECUTIVE SERVICE
RATINGS AND PAY-FOR-PERFORMANCE SUMMARY DATA REPORT
Part A – GENERAL INFORMATION
1. Agency or Component(s) – Enter the agency or component(s) covered
by the SES performance appraisal system being reported.
2. Date – Enter the date of this report.
3. Point of Contact – Enter the full name of the agency point of contact.
4. Points of Contact’s Telephone Number – Enter the area code and
phone number, including extension.
5. Point of Contact’s Email Address – Enter the complete email address.
6. SES Performance Appraisal System Certification – Enter an “X” in the
field that describes your agency’s SES performance appraisal certification
type, if applicable. If your agency’s SES performance appraisal system is
not certified, enter an “X” in the “N/A” field.
7. SES Performance Appraisal System Certification Date – Enter the date
your agency’s SES performance appraisal system was certified, if
applicable.
8. Performance Cycle – Enter the beginning and ending dates of your
agency’s SES performance appraisal period.
9. Summary Rating Pattern –
Enter “D” for rating levels 1, 2, and 3.
Enter “F” for rating levels 1, 2, 3, and 5.
Enter “G” for rating levels 1, 2, 3, and 4.
Enter “H” for rating levels 1, 2, 3, 4, and 5.
10. Total SES Members – Enter the total number of SES members, including
career, non-career, and limited term.
11. Total SES Members Eligible to be Rated – Enter the total number of
SES members eligible to be rated.
12. Total SES Members Not Rated – Enter the total number of SES members
who did not receive a performance rating for the reported performance
cycle (for example, those who were not under an appraisal cycle for the
minimum period of time).
Part B – DATA
1. Number of SES Members - Enter the number of SES members to which
the data entries apply. If the number is more than 1, all data items,
including aggregate compensation, must be identical for each member for
this line entry. For example, if there are 20 members whose data items
are identical; put the number ''20'' in the cell. If the data is different in any
of the cells in that row, you should enter the member’s data in a different
row. In other words, all data items must be identical for grouped data.
2. Appt Type - Enter the appointment type for the SES member using “C” for
Career, “N” for Non-Career, or “L” for Limited appointments.
3. New Appt – Enter an “X” in the field if the SES member is newly appointed
to the agency or component and has not received a performance rating or
pay adjustment based on the reported performance cycle.
4. Rating – Enter the SES member’s summary rating for the reported
performance cycle. The summary rating will be one of the following:
• “5” for Outstanding or equivalent
• “4” for Exceeds Fully Successful or equivalent
• “3” for Fully Successful or equivalent
• “2” for Minimally Successful or equivalent
• “1” for Unacceptable or equivalent
• “N” for Not Rated
5. Rate of Basic Pay Prior to Performance-Based Pay Adjustment –
Enter the SES member’s rate of basic pay at the end of the reported
performance cycle.
6. Rate of Basic Pay After Performance-Based Pay Adjustment – Enter
the SES member’s rate of basic pay after all performance-based pay
adjustments have been made, following the end of the reported
performance cycle.
7. Pay Amount to Maintain Relative Position – If applicable, enter the
amount of any increase in the rate of basic pay of the SES member made
for the purpose of maintaining the member's relative position in the SES
rate range (under 5 CFR 534.404(b)(4)(i).
8. Pct. of Performance-Based Pay Adjustment - Enter the percentage of
basic salary representing the SES member's basic pay adjustment
associated with performance.
9. Performance Award Pool Amount (in dollars and percent) - Enter the
dollar amount set aside for the agency's SES performance awards and the
percentage of aggregate base pay on which these awards were
calculated. The total amount of the performance pool paid during a fiscal
year by an agency may not exceed the greater of:
• Ten percent of the aggregate career or SES rates of basic pay for
the agency as of the end of the fiscal year prior to the fiscal year in
which the award payments are made, or
• Twenty percent of the average annual rates of basic pay for career
SES appointees of the agency as of the end of the fiscal year prior
to the fiscal year in which the award payments are made.
10. Performance Amount - If applicable, enter the dollar amount of the
performance award received by the SES member for the reported
performance cycle.
11. Performance Pct. - Enter the percentage of basic pay for the
performance award received by the SES member for the reported
performance cycle.
12. Cash Amount - Enter the dollar amount received by the SES member for
individual or group cash awards during the reported performance cycle.
13. Cash Pct. – Enter the percentage of basic pay received by the SES
member in the form of individual or group cash awards during the reported
performance cycle.
14. Distinguished Presidential Rank Amount - Enter the dollar amount
of the Presidential Rank Award received by the SES member during the
fiscal year. This amount is equal to 35% of the SES member's base pay.
15. Meritorious Presidential Rank Amount - Enter the dollar amount of
the Meritorious Presidential Rank received by the SES member during the
fiscal year. This amount is equal to 20% of the SES member's base pay.
16. Aggregate Compensation Amount - Enter the dollar amount of total
aggregate compensation as defined in 5 CFR Part 530, Subpart B, as of the
end of the calendar year.
Part C - Comments
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