OPM Form 1828
DATA ELEMENT/NEW REQUIREMENT REQUEST FORM
External Use Version
To be filled out and submitted electronically with the initial request.
1. AGENCY: 2. DATE:
3. Name and title of person making this request or contact fo r the data element:
4. Is this request from a Shared Service Center (SSC)? 5. If so, which one?
6. Has this request been discussed with other SSCs?
7. If yes to Item 6, list all SSCs and their positio n w ith this request (in agreement; needs to be modif ied; not required, etc.) :
9. City: 10. State: 11. ZIP Code:
12. Phone Number:
14. What data needs to be captured? (please provide information that is as specific and in-depth as possible including an example of
15. What is the purpose for the data colle ct ion? (ad-hoc analysis, administrative, mandated reporting requirement, etc.)
16. Legal authority/ justification/req uirem ent to report the data (if a p plicable):
17. Additional information:
18. For more information conta ct: 19. Phone number/e-mail:
To be filled out upon request
20. Does this information already exist?
Yes No N/A
21. What is the tim e line associated with this request?
22. Based on your current kn owledge, what are some of the consideration s in implementing this request?
23. To what EHRI feeds will this data b e reported? (i.e., status, dyn a m ics, pay, training, mili tary)
24. What is your initial collection s trateg y? (Is the data already availab le?; Will it be required retrospectively?; How wi ll the data set be
initially populated?; Will it be rep orted for everyone, only as needed?; What is the communication pl an to ag encies?, etc.)
25. What is your maintenance strategy? (How often will the element be reviewed and updated?)
FORWARD REQUEST TO:
Instructions for completion of the Data Element/New Request
Item 1, Agency – Indicate the agency requesting this change. (Spell out agency names - do not use only
Item 2, Date – Date the form is filled out. Enter MM/DD/YYYY.
Item 3, Name and Title- Indicate the person and their title. Please note, this person may be contacted if
additional information is required.
Item 4, Origin of the request (SSC) – Indicate ‘Yes’ if this request is originating for a Shared Service Center
(SSC). Indicate ‘NO’ if it is not coming from a SSC.
Item 5, Which SSC – If the answer to item 4 is ‘Yes’, indicate which SSC is making the request.
Item 6, Discussions with other SSCs – Respond with either ‘Yes’, ‘No’ or ‘N/A’.
Item 7, Response from SSCs – If the response to item 6 is ‘Yes’, then list each SSA and your perception of their
position with this request.
Item 8, Location – Indicate the location of the office making the request, please include suite numbers and/or
Items 9, 10 and 11 – Indicate City, State and ZIP Code.
Item 12, Phone number – Indicate the Point of Contact’ s (POC) phone number.
Item 13, e-mail address – Indicate the POC’s e–mail address.
Item 14, What data is needs to be captured? – Provide specific information on the type of data.
Item 15, What is the purpose for the data collection? – Provide in-depth information on the purpose of the
data collection (for example, using the data for workforce analysis).
Item 16, Legal authority or justification – Indicate legal authority, if non exists indicate n/a
Item 17, Additional Information – Provide any additional information that you believe would be helpful in
assessing this request.
Section 2 should be filled out ONLY at the request of the Center for Workforce Information &
Systems Requirements (CWISR). This may occur after the review of the information in Section 1.
Item 20, Does this information already exist? – If you are not sure if it is currently being collected please
ITEM 21, What is the timeline associated with this request? – Indicate when you would like to have this
Item 22, List any consideration the team should be aware of as they review this request- Include any
information you may have on the intern al or external impact of this request.
Item 22, To what EHRI feeds will this data be reported? - List all feeds you are aware of that may be
Item 23, What is your initial collection strategy? – Include the current status.
Item 24, What is your maintenance strategy? – Remember to include how often and how you plan to
Direct all comments and questions to: [email protected]