Request to Hired Retired Military Members

with the servicing Command Staff Advisor (CSA). This must be completed whenever requesting to hire a

retired Coast Guard military member or other retired military members recently detailed or assigned to the

Department of Transportation (see COMDTINST 12300.6J). The following signatures are required:

(1) the request of the selecting official; (2) endorsement by the area or district commander,

commanders of maintenance and logistics commands, commanding officers of Headquarters units,

or by a Headquarters Flag/SESlevel official if the request covers a Headquarters position; (3) the

CSA and (4) other approving officials are to be recorded below. Each signature certifies that full

and fair competition was provided, and that the selectee has not been accorded any undue advantage

over other applicants.

REQUEST, ENDORSEMENT AND APPROVALS

Official

Signature

Date

Selecting Official

Endorsement of the Commander of an

area, district, or maintenance &

logistics command, Commanding

Officer of a Headquarters unit,

or Flag/SES official if HQ employee.

Command Staff Advisor

Commander (CGPC-cpm)

Commandant (G-WPC)

Please attach the following items to this request:

1. Copies of the proposed appointee's:

a. job application or resume;

b. DD-214 or retirement letter with approved retirement date, or documentation

showing a planned or expected retirement date.

2. Copies of:

a. the position description;

b. vacancy announcement(s);

c. all certificates of eligibles and requests which contain selective factors.

3. Please answer the following:

a. When was the position vacated ________________ or, if new or redescribed,

when was the position established or redescribed? ______________