Fillable Printable SF 62
Fillable Printable SF 62
SF 62
SF 62
Revised April 2011
All previous editions not usable
NSN-7540-00-634-1017
U.S. Office of Personnel Management
Agency Request to Pass Over a Preference Eligible or Object to an Eligible
Part A - Qualifications or Conduct Reasons
INSTRUCTIONS: This form must be used to object to an eligible or to request authority to pass over a preference eligible and appoint a nonpreference
eligible. Submit this form in duplicate along with all available information and documents considered pertinent to the case, i.e., vacancy announcement,
position description, application, certificate of eligibles, service record, etc. One copy will be returned to you with the decision. Pending approval of an
agency's objection to an eligible or request for pass over, the agency may not appoint an eligible who would be within reach only if the action is approved.
Specific processing and mailing instructions are in the Delegated Examining Operations Handbook, Chapter 6, Section D, Object to an Eligible.
Reference 5 CFR 332.406.
1. Agency Contact (Name and Mailing Address)
2. E-mail Address
3. Telephone Number
4. Name and Address of Eligible (First, MI, Last – Street, City, State and ZIP Code)
5. Rating 6. Certificate Number 7. Date of Certificate
8. Position Title and Grade or Equivalent
9. Title of Examination
Reasons for Objection/Pass Over
We object to the eligible indicated above for reasons of:
Qualifications
Conduct (under 5 CFR 731)
We propose to pass over this preference eligible to select a nonpreference eligible for reasons of:
Qualifications
Conduct (under 5 CFR 731)
Veteran has a service-connected disability of 30 percent or more and has been notified of this action, of the reasons for it, and of his or her right to
respond to the U.S. Office of Personnel Management within 15 days of the notice in accordance with 5 U.S.C. 3318(b)(2).
(Attach copy of notification.)
REASONS: State reasons specifically and clearly so that the significance is readily apparent. Eligibles have the right to request and review the
reasons for these actions. The reasons, therefore, cannot be considered confidential. (Attach additional sheet, if necessary.)
Signature and Title of Agency Appointing Official
Telephone Number (Including Area Code) Date (Month, Day, Year)
OPM/Agency Decision
The action is sustained and the eligible is removed from consideration.
The action is not sustained for the following reasons:
Signature and Title of Agency Official or OPM Official
Date (Month, Day, Year)
U.S. Office of Personnel Management
5 CFR part 332 and 338
SF 62
Revised April 2011
All previous editions not usable
NSN-7540-00-634-1017
Part B – Medical Reasons for Passing Over a Preference Eligible
INSTRUCTIONS TO AGENCY APPOINTING OFFIICIAL: Use of Part B is restricted to medical decisions resulting in a pass over of a preference
eligible. A pass over is an objection submitted by an agency against a preference eligible that results in the selection of a non-preference eligible.
A CP-S eligible is a veteran with a service-connected disability of 30 percent or more determined by the Department of Veterans Affairs or a branch of
the Armed Forces. When submitting this form in duplicates, be sure to attach a position description, the eligible's application or work history and all
pertinent, current medical evidence and prior reports leading to your decision. One copy of this form will be returned to you with OPM's decision.
Specific processing and mailing instructions are in the Delegated Examining Operations Handbook, Chapter 6, Section D, Object to an Eligible.
Reference 5 CFR 339.
1. Agency Contact (Name and Mailing Address)
2. E-mail Address
3. Telephone Number
4. Name and Address of Eligible (First, MI, Last – Street, City, State and ZIP Code)
5. Rating 6. Certificate Number 7. Date of Certificate
8. Position Title and Grade or Equivalent
9. Title of Examination
Action Proposed
Pass over the preference eligible named above and select a non-preference eligible
Pass over the veteran named above with a service-connected disability of 30 percent or more and select a non-preference eligible. The veteran has
been notified of this action, the reasons for it, and his or her right to respond to the U.S. Office of Personnel Management within 15 days of the notice
in accordance with 5 U.S.C. 3312(b). (Attach copy of notification.)
Medical Reasons: Briefly explain your decision as it relates to the physical requirements and environmental conditions of the position.
(Attach additional sheet, if necessary.)
Name and Title of Agency Appointing Official
Telephone Number (Including Area Code) Date (Month, Day, Year)
OPM Decision
Action is sustained (See remarks concerning applicant’s future eligibility for these positions.)
Action is not sustained for reasons noted under Remarks.
Remarks
Signature and Title of OPM Official
Date (Month, Day, Year)
U.S. Office of Personnel Management
5 CFR part 332 and 339
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